Podcasts about Virginia Commonwealth University

In this episode, we're joined by Prof. Andrew Crislip, who is Blake Chair in the History of Christianity at Virginia Commonwealth University, and the author of Emotion in Early Christianity (published by Eerdmans). In our conversation, Prof. Crislip talks with us about what emotions really are, what early Christians thought about five key emotions, and how that thinking evolved within the first five centuries of the church. Team members on the episode from The Two Cities include: the Rev. Dr. Nathaniel Adishian and Dr. John Anthony Dunne. Hosted on Acast. See acast.com/privacy for more information.

 In this episode of the PQS Quality Corner Show, hosts Kerri Musselman and Emily Endres celebrate Heart Health Month by exploring the critical link between community pharmacy, maternal health, and cardiovascular wellness. Their guest, Andrea Brookhart (Director of Population Health and Wellness at Kroger), shares her insights as both a clinical leader and a mother of twins.This episode touches on the Pharmacist as an accessible ally, the "Silent Killer" and prevention, gender differences in cardiac care, the "Mom Factor,” and self-care.Dr. Andrea Brookhart is a community pharmacist who is passionate about helping people live healthier lives.  In her role, she develops and implements Kroger Health's strategy for achieving population health via value-based care.  She believes community-based providers are uniquely poised to improve healthcare quality and decrease cost by delivering preventive healthcare and improving medication use.Dr. Brookhart is a graduate of the University of Toledo College of Pharmacy & Pharmaceutical Sciences and of Virginia Commonwealth University's Community-based Pharmacy Residency Program a Board Certified Ambulatory Care Pharmacist. 

In this episode of The Pencil Pushers Podcast, host Mike Rosado sit down with artist, writer, and creative director Will Carsola of Liquid Death to trace his path from drawing for laughs as a kid to shaping one of the boldest brands in modern marketing. Will talks about growing up mostly in Virginia, early influences like Garbage Pail Kids, and how humor became central to his voice as an artist. He shares stories of leaving Virginia Commonwealth University, bartending to get by, and spending years making DIY sketch comedy and early animation before YouTube helped his work gain traction. The conversation also covers his collaboration with Dave Stewart, pitching Adult Swim, and how a key creative shift led to the cult hit Mr. Pickles, which ran for three seasons and spawned the spinoff Mama Named Me Sheriff. Will then dives into his journey with Liquid Death, from creating the skull logo and early campaigns to becoming creative director, and discusses the brand's philosophy of making fun of marketing, the balance of edgy humor, and his creative approach: make things for the love of it, lower the pressure, and use "write-offs" to unlock great ideas. Host: Mike Rosado (mrcraleigh.com) (instagram.com/ekimodasor) Post Production: Max Trujillo (instagram.com/trujillomedia) Sponsors: MRC (mrcraleigh.com) and Burny Wild's (burnywilds.com) 

From sandblasting pipe yards at 17 to advising on $10-200M M&A transactions, Dr. Greg Waller shares proven strategies for maximizing business exit value, managing buyer expectations, and why the best time to prepare for sale is 3 years before you're ready. In this episode of the DealQuest Podcast, host Corey Kupfer sits down with Dr. Greg Waller, who advises clients on complex business valuation and buy-side and sell-side M&A transactions. Greg is the managing partner of Cornerstone Valuation and a partner and managing director of Transact Capital, leading a 20-person team focused on the lower middle to middle market. Given his academic and entrepreneurial background, he jokingly refers to himself as the Blue Collar Scholar. WHAT YOU'LL LEARN: In this episode, you'll discover why professional buyers and owner-operators require completely different M&A processes, how to set realistic expectations about the gap between business value and market price, and why starting exit preparation 3 years in advance dramatically impacts final sale outcomes. Greg explains how private equity-backed platforms are blurring the traditional lines between financial and strategic buyers, what makes labor-intensive businesses particularly attractive in the current market, and the cultural complexities that emerge in international transactions. You'll also learn why the most successful exits often begin as casual conversations years before any actual sale decision. GREG'S JOURNEY: Greg's path to M&A advisory started in Youngstown, Ohio at age 17. He walked into a pipe yard with a 4-inch piece of pipe, half sandblasted and coated, half rusty. He showed the crew his before-and-after demo and landed a contract to blast the entire yard over 18 months. That first deal led to years painting elevated structural steel, bridges, water tanks, and radio transmission towers. The industry changed when EPA regulations around lead-based paint removal came in. Working on a bridge one day, a coworker with cracked hands from years of painting looked at Greg and said, "Look at my hands, look at my face. What are you doing? You're a smart boy, why don't you go back to school?" That conversation took the rest of the season to sink in, but Greg eventually left the painting business and pursued his MBA at Ohio University. Faculty members encouraged him to pursue a PhD. His initial reaction was "Are you crazy? Why would I ever want to do a PhD?" But they convinced him, and he earned his PhD in finance at Purdue University. During his 20 years in academics at Ohio University and Virginia Commonwealth University (until May 2025), Greg maintained entrepreneurial ventures including valuation work as an expert witness, real estate development, buying his father's distribution company, and building a restaurant operating group. THE BLUE COLLAR SCHOLAR: Greg's unique combination of blue-collar operations experience and academic expertise gives him a perspective most M&A advisors lack. As he puts it, "I'm as comfortable talking to the janitor as I am to a board of directors, and just being able to put yourself in those shoes and having done it really gives you a different perspective." Having been under the hood of companies across virtually every industry through ownership and valuation work, he can get into the head of sellers in ways that matter when emotions run high and expectations need managing. KEY INSIGHTS: The M&A market divides into two buyer pools requiring vastly different processes. Professional buyers (private equity and strategics) respond to structured competitive auction processes with rigorous due diligence. Owner-operators typically engage through market-making platforms where price leads the conversation. Understanding which buyer type you're targeting shapes everything about your approach. Value and price represent fundamentally different concepts. Greg uses GameStop as his example: price went through the roof despite no fundamental change to the company, then crashed. Setting realistic expectations upfront with clients about valuation ranges prevents painful surprises when market realities emerge. The critical question: "If this thing ends up pricing at the lower end of the range, are we still good to go?" The consultative approach produces the best outcomes. Greg's most successful deals were "3 or 5 years in the making" where he identified value drivers early, helped clients clean up their operations, and positioned them properly before market entry. The best time to start thinking about hitting the market is 3 years ago. Private equity-backed platforms now dominate middle-market transactions, acting like strategics by bolting on competitors but bringing institutional capital discipline. This hybrid model has made the traditional financial versus strategic buyer distinction increasingly blurry. Labor-intensive businesses with skilled workforces are commanding premium multiples as immigration policies create labor challenges. Service providers to infrastructure industries and staffing companies are particularly hot. With massive private equity dry powder and 2024's weak M&A activity, the ingredients point toward a robust 2026 market. Perfect for business owners planning exits in the next 3-5 years, entrepreneurs considering M&A advisory relationships, and anyone interested in understanding how blue-collar operations experience combined with academic expertise creates differentiated advisory value. FOR MORE ON THIS EPISODE: https://www.coreykupfer.com/blog/gregwaller FOR MORE ON GREG WALLER:https://www.linkedin.com/in/h-gregory-waller-7193bb60/https://www.facebook.com/profile.php?id=61573615328301 FOR MORE ON COREY KUPFER https://www.linkedin.com/in/coreykupfer/ https://www.coreykupfer.com/ Corey Kupfer is an expert strategist, negotiator, and dealmaker. He has more than 35 years of professional deal-making and negotiating experience. Corey is a successful entrepreneur, attorney, consultant, author, and professional speaker. He is deeply passionate about deal-driven growth. He is also the creator and host of the DealQuest Podcast. Get deal-ready with the DealQuest Podcast with Corey Kupfer, where like-minded entrepreneurs and business leaders converge, share insights and challenges, and success stories. Equip yourself with the tools, resources, and support necessary to navigate the complex yet rewarding world of dealmaking. Dive into the world of deal-driven growth today! Episode Highlights with Timestamps [00:12:39] - Introduction: Greg Waller's credentials and Blue Collar Scholar background [00:16:32] - First deal at 17: Landing the pipe yard sandblasting contract [00:20:04] - The bridge painter who told him to go back to school and career transformation [00:29:05] - How blue-collar and academic backgrounds create unique M&A advisory perspective [00:30:48] - Two buyer pools: Professional buyers versus owner-operators and their different processes [00:35:57] - Value versus price conversation and the GameStop example [00:47:05] - "The best time to start thinking about hitting the market is 3 years ago" [00:48:21] - Why the line between financial and strategic buyers is increasingly blurry [00:50:15] - International deal complexities and cultural differences [00:54:19] - Market outlook for 2026: Labor challenges driving premium multiples [00:57:40] - What freedom means: Clean conscience and ability to chart your own destiny Guest Bio Dr. Greg Waller advises clients on complex business valuation and buy-side and sell-side M&A transactions. He is the managing partner of Cornerstone Valuation and a partner and managing director of Transact Capital, leading a 20-person team focused on the lower middle to middle market ($10-200M enterprise value range). His key industry verticals include human resource companies, staffing, industrials and infrastructure, healthcare, technology, and consumer products. Greg holds a PhD in finance from Purdue University and, until May 2025, was a tenured professor at Virginia Commonwealth University, where he taught courses and published research on corporate finance, mergers and acquisitions, and corporate governance. He previously taught at Ohio University. Greg is the son of a blue-collar entrepreneur and owned and operated an industrial painting company specializing in elevated structural steel infrastructure before pursuing his academic career. He has also been a partner in a real estate development firm and restaurant operating group, and now owns his family's industrial painting equipment distribution company. Given his academic and entrepreneurial background, he jokingly refers to himself as the Blue Collar Scholar. Host Bio Corey Kupfer is an expert strategist, negotiator, and dealmaker with more than 35 years of professional deal-making and negotiating experience. Corey is a successful entrepreneur, attorney, consultant, author, and professional speaker deeply passionate about deal-driven growth. He is the creator and host of the DealQuest Podcast. Show Description Do you want your business to grow faster? The DealQuest Podcast with Corey Kupfer reveals how successful entrepreneurs and business leaders use strategic deals to accelerate growth. From large mergers and acquisitions to capital raising, joint ventures, strategic alliances, real estate deals, and more, this show discusses the full spectrum of deal-driven growth strategies. Get the confidence to pursue deals that will help your company scale faster. Related Episodes Episode 350 - Tom Dillon: Understanding Business Valuation and Exit Planning Realities Episode 325 - Kelly Finnell: Using ESOPs in Ownership Succession Planning Episode 330 - Pete Mohr: Building Enterprise Value and Exit Readiness Episode 339 - Solocast 74: Equitizing Key Employees and Succession Planning Strategies Follow DealQuest Podcast: LinkedIn: https://www.linkedin.com/in/coreykupfer/ Website: https://www.coreykupfer.com/ Follow Greg Waller:https://www.linkedin.com/in/h-gregory-waller-7193bb60/https://www.facebook.com/profile.php?id=61573615328301 Keywords/TagsM&A advisory, business valuation, exit planning, sell-side advisory, lower middle market, professional buyers, strategic buyers, private equity, business sale preparation, enterprise value, Blue Collar Scholar, deal structuring, owner-operators, business exit strategy, middle market M&A, exit readiness, business succession planning, international M&A, cross-border transactions, 2026 market outlook

Superpowers for Good should not be considered investment advice. Seek counsel before making investment decisions. When you purchase an item, launch a campaign or create an investment account after clicking a link here, we may earn a fee. Engage to support our work.Watch the show on television by downloading the e360tv channel app to your Roku, LG or AmazonFireTV. You can also see it on YouTube.Devin: What is your superpower?Sanjana: Connecting the dots.Technology is often seen as a solution to the world's biggest challenges, but it can also be a source of harm. In today's episode, Sanjana Paul, the Executive Director of Rooted Futures Lab, shared how her organization is bridging the gap between technology and environmental justice to create a more equitable and sustainable future.Sanjana explained that environmental justice, as a concept, ensures equal protection from environmental harm, regardless of income, race, or geography. She shared a disturbing insight from Dr. Robert Bullard's research: low-income communities and communities of color are disproportionately burdened by pollution and environmental hazards. “A kid anywhere in the world should be able to breathe and not be breathing in pollution,” Sanjana said.Rooted Futures Lab is tackling this challenge by merging education, research, and action. A key initiative involves hosting environmental hackathons, where young scientists and engineers learn to develop technologies with environmental awareness at their core. “We see hackathons as a fun and community-centric way to introduce hands-on environmental education,” she explained. These events inspire the next generation of engineers to think critically about the environmental impact of their innovations.The organization also collaborates with students and researchers to reimagine technologies like refrigeration systems through workshops that focus on reducing environmental harm. Additionally, they are conducting research on digital infrastructure, such as data centers, to analyze their environmental impact and propose sustainable alternatives.“We should be trying to be better engineers,” Sanjana emphasized. “How can we build transit systems that get us from one place to another without giving a kid asthma?” Her work highlights how technology, when approached thoughtfully, can be used to address systemic inequities and reduce environmental harm.By focusing on educating future engineers, conducting groundbreaking research, and fostering collective action, Sanjana and Rooted Futures Lab are paving the way for a greener, fairer future.tl;dr:Sanjana Paul defines environmental justice and explains its connection to technology and systemic inequities.Rooted Futures Lab educates young engineers through hackathons to foster environmentally conscious innovation.Sanjana highlights key projects, including research on digital infrastructure and sustainable design workshops.She shares how her superpower, connecting the dots, enables her to bridge fields for positive impact.Sanjana encourages collaboration, curiosity, and deep thinking to address environmental challenges effectively.How to Develop Connecting the Dots As a SuperpowerSanjana describes her superpower as “connecting the dots.” She shared how her diverse background in electrical engineering, environmental science, and energy policy allows her to see links between seemingly unrelated fields. “These dots may not seem like they connect, but they really do to me,” Sanjana said. Her ability to uncover these connections enables her to address complex challenges, like bridging environmental justice and technology, with a holistic approach.Sanjana's work at Rooted Futures Lab exemplifies her superpower. While working in atmospheric sensing, she observed the devastating impacts of extreme weather events and pollution. This inspired her to connect environmental justice with technology, leading to the creation of Rooted Futures Lab. The organization now focuses on educating engineers about the environmental impacts of technology, hosting hackathons, and reimagining infrastructure to align with environmental justice principles.Tips for Developing the Superpower:Be Curious: Treat every moment as an opportunity to learn or teach.Think Holistically: Look for connections between seemingly unrelated fields or ideas.Engage with Others: Work collaboratively in a community to tackle complex problems.Slow Down: Take time to reflect on root causes instead of reacting to immediate issues.Learn from Experts: Seek knowledge from those working in areas you want to understand better.By following Sanjana's example and advice, you can make connecting the dots a skill. With practice and effort, you could make it a superpower that enables you to do more good in the world.Remember, however, that research into success suggests that building on your own superpowers is more important than creating new ones or overcoming weaknesses. You do you!Get Your Copy!Guest ProfileSanjana Paul (she/her):Executive Director, Rooted Futures LabAbout Rooted Futures Lab: Rooted Futures Lab advances environmental justice in technology through education, research, and action. We support communities and advocates contesting digital infrastructure's environmental and social impacts through accessible tools, public scholarship, and organizing resources.Website: rootedfutureslab.ioLinkedIn Profile: linkedin.com/company/rooted-futures-labBiographical Information: Sanjana Paul is an engineer, environmental justice researcher, and systems thinker working at the intersection of infrastructure, climate, and technology. She is a PhD student at MIT, where her research focuses on renewable energy, energy justice, and the electric grid. She is the co-founder and Executive Director of Rooted Futures Lab, a research and action collective advancing environmental justice in technology, and the co-founder of Earth Hacks, a nonprofit that uses hackathons as a form of climate action and public learning. Her work has ranged from atmospheric science software engineering at NASA to passing decarbonization policy at the local level. She holds a BS in electrical engineering and physics from Virginia Commonwealth University and a Master's in City Planning from MIT.LinkedIn Profile: linkedin.com/in/sanjana-paul-79081a111The Super Crowd, Inc., a public benefit corporation, is proud to have been named a finalist in the media category of the impact-focused, global Bold Awards.Support Our SponsorsOur generous sponsors make our work possible, serving impact investors, social entrepreneurs, community builders and diverse founders. Today's advertisers include rHealth, and Make Money with Impact Crowdfunding. Learn more about advertising with us here.Max-Impact Members(We're grateful for every one of these community champions who make this work possible.)Brian Christie, Brainsy | Cameron Neil, Lend For Good | Carol Fineagan, Independent Consultant | Hiten Sonpal, RISE Robotics | John Berlet, CORE Tax Deeds, LLC. | Justin Starbird, The Aebli Group | Lory Moore, Lory Moore Law | Mark Grimes, Networked Enterprise Development | Matthew Mead, Hempitecture | Michael Pratt, Qnetic | Mike Green, Envirosult | Nick Degnan, Unlimit Ventures | Dr. Nicole Paulk, Siren Biotechnology | Paul Lovejoy, Stakeholder Enterprise | Pearl Wright, Global Changemaker | Scott Thorpe, Philanthropist | Sharon Samjitsingh, Health Care Originals | Add Your Name HereUpcoming SuperCrowd Event CalendarIf a location is not noted, the events below are virtual.SuperCrowd Impact Member Networking Session: Impact (and, of course, Max-Impact) Members of the SuperCrowd are invited to a private networking session on February 17th at 1:30 PM ET/10:30 AM PT. Mark your calendar. We'll send private emails to Impact Members with registration details. Upgrade to Impact Membership today!SuperCrowdHour February: This month, Devin Thorpe will be digging deep into my core finance expertise to share guidance on projections and financial statements. We're calling it “Show Me the Numbers: Building Trust with Financial Clarity.” Register free to get all the details. February 18th at Noon ET/9:00 PT.Superpowers for Good Live Pitch: The top-raising Reg CF campaign of 2025 won the June 2025 Superpowers for Good Live Pitch. We're taking applications for the March 17, 2026, Live Pitch now. There is no fee to apply and no fee to pitch if selected! 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Today, we're putting The Tonearm's needle on Stephen Vitiello.Stephen is an electronic musician and media artist. His sound installations are in the permanent collections of MoMA, the Whitney, and the Museum of Contemporary Art in Lyon. He's worked with Pauline Oliveros, Ryuichi Sakamoto, and Joan Jonas. By day, he teaches Kinetic Imaging at Virginia Commonwealth University.Stephen's latest project is Trinity, a collaborative album with Lawrence English, who you heard on last week's show. Each of Trinity's five tracks brings in a different third musician: Brendan Canty from Fugazi, Chris Abrahams from The Necks, Marina Rosenfeld, Aki Onda, and the late Steve Roden. The album came out last November.Stephen shares how this project came together, what it's like to work with each of these artists, and how he's built a career turning everyday sounds into sonic experiences.(The musical excerpts heard in the interview are from Lawrence English & Stephen Vitiello's album Trinity)–Dig DeeperArtist and AlbumVisit Stephen Vitiello at stephenvitiello.com and follow him on Soundcloud, Instagram, and BandcampPurchase Lawrence English & Stephen Vitiello's Trinity from American Dreams, Bandcamp, or Qobuz and listen on your streaming platform of choicePrevious collaborations: Acute Inbetweens (2011) and Fable (2014) with Lawrence EnglishStephen Vitiello & Brendan Canty: Second (with Hahn Rowe)Trinity CollaboratorsLawrence English and Room40 RecordsBrendan Canty - drummer (Fugazi, The Messthetics)Chris Abrahams - pianist (The Necks)Marina Rosenfeld - turntablist and composerAki Onda - electronic musician and sound artistSteve Roden - late sound artist and visual artistWorld Trade Center ProjectWorld Trade Center Artist Residency - Lower Manhattan Cultural CouncilWorld Trade Center Recordings: Winds After Hurricane Floyd (1999)Bright and Dusty Things - album featuring WTC recordingsStephen Vitiello: Listening With Intent - documentary by ABC-TV AustraliaEducational InstitutionVCU Kinetic Imaging - Virginia Commonwealth UniversityKinetic Imaging Graduate Program at VCUInfluences and Collaborators MentionedNam June Paik - video art pioneerPauline Oliveros - composer and accordionistRyuichi Sakamoto - composer and musicianFred Frith - guitarist and composerIkue Mori - drummer and electronic musician (DNA)Maryanne Amacher - sound artist and composerR. Murray Schafer - composer and writer on acoustic ecologyRobin Rimbaud (Scanner) - electronic musicianColin Newman - Wire guitarist and vocalistTaylor Deupree - 12k Records founderKey Venues and InstitutionsThe Kitchen - New York performance spaceElectronic Arts Intermix - video art distributorAnthology Film Archives - New York cinemaMASS MoCA - Massachusetts Museum of Contemporary ArtThe High Line - New York elevated parkWhitney Museum of American Art - 2002 BiennialMuseum of Modern Art - Soundings exhibition (2013)Punk and No Wave ReferencesFugazi - influential post-hardcore bandDNA - no wave bandThe ClashNo Wave movement - late 1970s NYCMusic Theory and PracticeFluxus movement - experimental art movementJohn Cage and prepared pianoAmbisonic audio - spatial sound formatDolby Atmos - immersive audio formatArticles and InterviewsSteve Roden and Stephen Vitiello conversation in Bomb magazineThe Collaborative Recent History of Stephen Vitiello - Fluid Radio interview-Dig into this episode's complete show notes at podcast.thetonearm.com–• Did you enjoy this episode? Please share it with a friend! You can also rate The Tonearm ⭐️⭐️⭐️⭐️⭐️ and leave a review on Apple Podcasts. • Subscribe! Be the first to check out each new episode of The Tonearm in your podcast app of choice. • Looking for more? Visit podcast.thetonearm.com for bonus content, web-only interviews + features, and the Talk Of The Tonearm email newsletter. You can also follow us on Bluesky, Mastodon, YouTube, and LinkedIn. • Be sure to bookmark our online magazine, The Tonearm! → thetonearm.com Hosted on Acast. See acast.com/privacy for more information.

Today, we're putting The Tonearm's needle on Stephen Vitiello.Stephen is an electronic musician and media artist. His sound installations are in the permanent collections of MoMA, the Whitney, and the Museum of Contemporary Art in Lyon. He's worked with Pauline Oliveros, Ryuichi Sakamoto, and Joan Jonas. By day, he teaches Kinetic Imaging at Virginia Commonwealth University.Stephen's latest project is Trinity, a collaborative album with Lawrence English, who you heard on last week's show. Each of Trinity's five tracks brings in a different third musician: Brendan Canty from Fugazi, Chris Abrahams from The Necks, Marina Rosenfeld, Aki Onda, and the late Steve Roden. The album came out last November.Stephen shares how this project came together, what it's like to work with each of these artists, and how he's built a career turning everyday sounds into sonic experiences.(The musical excerpts heard in the interview are from Lawrence English & Stephen Vitiello's album Trinity)–Dig DeeperArtist and AlbumVisit Stephen Vitiello at stephenvitiello.com and follow him on Soundcloud, Instagram, and BandcampPurchase Lawrence English & Stephen Vitiello's Trinity from American Dreams, Bandcamp, or Qobuz and listen on your streaming platform of choicePrevious collaborations: Acute Inbetweens (2011) and Fable (2014) with Lawrence EnglishStephen Vitiello & Brendan Canty: Second (with Hahn Rowe)Trinity CollaboratorsLawrence English and Room40 RecordsBrendan Canty - drummer (Fugazi, The Messthetics)Chris Abrahams - pianist (The Necks)Marina Rosenfeld - turntablist and composerAki Onda - electronic musician and sound artistSteve Roden - late sound artist and visual artistWorld Trade Center ProjectWorld Trade Center Artist Residency - Lower Manhattan Cultural CouncilWorld Trade Center Recordings: Winds After Hurricane Floyd (1999)Bright and Dusty Things - album featuring WTC recordingsStephen Vitiello: Listening With Intent - documentary by ABC-TV AustraliaEducational InstitutionVCU Kinetic Imaging - Virginia Commonwealth UniversityKinetic Imaging Graduate Program at VCUInfluences and Collaborators MentionedNam June Paik - video art pioneerPauline Oliveros - composer and accordionistRyuichi Sakamoto - composer and musicianFred Frith - guitarist and composerIkue Mori - drummer and electronic musician (DNA)Maryanne Amacher - sound artist and composerR. Murray Schafer - composer and writer on acoustic ecologyRobin Rimbaud (Scanner) - electronic musicianColin Newman - Wire guitarist and vocalistTaylor Deupree - 12k Records founderKey Venues and InstitutionsThe Kitchen - New York performance spaceElectronic Arts Intermix - video art distributorAnthology Film Archives - New York cinemaMASS MoCA - Massachusetts Museum of Contemporary ArtThe High Line - New York elevated parkWhitney Museum of American Art - 2002 BiennialMuseum of Modern Art - Soundings exhibition (2013)Punk and No Wave ReferencesFugazi - influential post-hardcore bandDNA - no wave bandThe ClashNo Wave movement - late 1970s NYCMusic Theory and PracticeFluxus movement - experimental art movementJohn Cage and prepared pianoAmbisonic audio - spatial sound formatDolby Atmos - immersive audio formatArticles and InterviewsSteve Roden and Stephen Vitiello conversation in Bomb magazineThe Collaborative Recent History of Stephen Vitiello - Fluid Radio interview-Dig into this episode's complete show notes at podcast.thetonearm.com–• Did you enjoy this episode? Please share it with a friend! You can also rate The Tonearm ⭐️⭐️⭐️⭐️⭐️ and leave a review on Apple Podcasts. • Subscribe! Be the first to check out each new episode of The Tonearm in your podcast app of choice. • Looking for more? Visit podcast.thetonearm.com for bonus content, web-only interviews + features, and the Talk Of The Tonearm email newsletter. You can also follow us on Bluesky, Mastodon, YouTube, and LinkedIn. • Be sure to bookmark our online magazine, The Tonearm! → thetonearm.com Hosted on Acast. See acast.com/privacy for more information.

Today's episode is a deep dive into tactile defensiveness and sensory distress, especially around clothing. My guest is Kathryn Hamlin-Pacheco, an occupational therapist who helps kids and families understand their brains and bodies through everyday neuroscience. Kathryn will break down what's actually happening in the brain and nervous system when children experience tactile defensiveness, and why clothing can feel so overwhelming for some kids. We talk about the role of co-regulation, how parents can help create positive associations with getting dressed, and practical strategies for supporting children in navigating their sensory experiences with more safety and less stress. This episode is a grounding, compassionate look at sensory processing—and a reminder that when we understand what's underneath the behavior, everything shifts. About Kathryn Hamlin-Pacheco Kathryn (Katie) Hamlin-Pacheco, M.S., OTR/L, ASDCS, is an occupational therapist, former teacher, author, and founder of the Brain Executive Program. Kathryn is an Autism Spectrum Disorder Clinical Specialist (ASDCS) and holds certifications in Neuroscience for Mental Health Professionals and in Brain Structure and Function: Application to Sensory Integration and Processing. She graduated from Virginia Commonwealth University with a Master's degree in Occupational Therapy, where she also worked with the Virginia Leadership Education in Neurodevelopmental Disabilities program to pursue her desire to be an advocate and leader in pediatric healthcare. She has shared her work at AOTA's Inspire Conference (the world's largest gathering of occupational therapy practitioners!), Sensory Integration Education's international conference, and at William & Mary's Center for Gifted Education. In addition, Katie has written for OT Practice Magazine, Autism Parenting Magazine, Washington Family Magazine, and Stars & Stripes Magazine. Her book, How to Be a Brain Executive: And Get Sensory Sharp!, was a top Amazon release in two categories. Things you'll learn from this episode  How tactile defensiveness reflects a nervous system response rather than behavioral resistance Why understanding sensory processing is essential for supporting children with clothing challenges How co-regulation helps children feel safe, connected, and more able to tolerate sensory input Why play and low-pressure practice can make clothing experiences more manageable How creating calm environments and positive associations supports sensory integration over time Why sensory health is a vital part of children's overall well-being Resources mentioned Brain Executive Program (Kathryn Hamlin-Pacheco's website) Kathryn's online Sensory Dressing Course How to Be a Brain Executive: And Get Sensory Sharp! by Kathryn Hamlin-Pacheco Brain Executive Program on Instagram Brain Executive Program on Facebook Deb Dana on Befriending Our Nervous System Using Polyvagal Theory (Tilt Parenting podcast) Dr. Stephen Porges & Karen Onderko on the Safe and Sound Protocol (Tilt Parenting podcast) Dr. Mona Delahooke on the Power of Brain-Body Parenting (Tilt Parenting podcast) Brain-Body Parenting: How to Stop Managing Behavior and Start Raising Joyful, Resilient Kids by Dr. Mona Delahooke Sensory Processing Differences with Carol Kranowitz (Tilt Parenting podcast) The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Differences by Carol Kranowitz Polyvagal Card Deck: 58 Practices for Calm & Change Polyvagal Practices: Anchoring the Self in Safety by Deb Dana Debbie's TedxBerlin talk: What if Feeling Broken Wasn't the End of the Story? Learn more about your ad choices. Visit podcastchoices.com/adchoices

Send us a textPharmacology & neurobiology of psychedelics & MDMA, focusing on isomers, sex-specific effects, and mechanisms in animal models. Not medical advice.TOPICS DISCUSSED:Biased agonism: Different drugs activate the same receptor (e.g., 5-HT2A) but trigger varied intracellular pathways, explaining why LSD is psychedelic while similar lisuride is not.Enantiomers & isomers: Mirror-image versions of drugs like MDMA (S and R forms) and LSD (four isomers) often produce distinct effects; only one LSD isomer is psychedelic, for example.MDMA isomer effects: S-MDMA induces stronger head twitches (psychedelic proxy) via serotonin release, and increases dendritic spines in male mice but not females; R-MDMA has somewhat different effects.Sex-specific drug responses: In mice, females show stronger psychedelic effects (head twitches) from psilocybin and DOI at the same dose, but males exhibit greater post-acute benefits like reduced opioid withdrawal.Psilocybin in opioid addiction models: A single dose reduces place preference for oxycodone and withdrawal symptoms in male mice more than females, with opposite spine density effects in reward-related brain areas.Mechanisms beyond 5-HT2A: Psychedelics involve other receptors like metabotropic glutamate receptors, forming dimers with 5-HT2A to enable dual signaling pathways; effects in subcortical regions like nucleus accumbens are 5-HT2A-independent.Clinical implications: Street MDMA may vary in S/R ratios, affecting experiences; clinical trials often use racemic mixtures without weight-adjusted dosing, potentially missing sex differences.ABOUT THE GUEST: Javier Gonzalez-Maeso, PhD is a professor of pharmacology and toxicology at Virginia Commonwealth University, with a PhD in medicine from Spain focused on G-protein coupled receptors and human brain studies in depression and addiction.RELATED EPISODE:M&M 230 | Psilocybin & MDMA: Inflammation, Stress & Brain-Body Communication | Michael WheelerSupport the showHealth Products by M&M Partners: SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off. Lumen device: Optimize your metabolism for weight loss or athletic performance. MINDMATTER gets you 15% off. AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models. Seed Oil Scout: Find restaurants with seed oil-free options, scan food products to see what they're hiding, with this easy-to-use mobile app. KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime) For all the ways you can support my efforts

In this episode, we're talking with Dr. Alaina Holt and Dr. Michelle Peace from the Laboratory for Forensic Toxicology Research about the importance of relationships within research, what they are seeing in the e-cigarette and cannabis product markets right now, the importance of sharing their findings with the community, and the role we all have to play in keeping our communities safe, healthy, and informed.    Referenced Resources: VCU Department of Forensic Science: https://forensicscience.vcu.edu/ VCU Laboratory for Forensic Toxicology Research: https://blogs.vcu.edu/mrpeace/ LFTR Research Materials: https://drive.google.com/drive/folders/1rndBDBH8N5Ie18HM0JqT_wJ4NhKNdaR7?usp=sharing Virginia Foundation for Healthy Youth: https://vfhy.org/   Dr. Peace is a forensic toxicologist and a Full Professor in the Department of Forensic Science at VCU. She is one of the founding faculty for the Department and served as Associate Chair and Chair for nearly a decade. Dr. Peace has also served as a manager in a private forensic drug testing laboratory and has worked as a scientist for Procter & Gamble, where she holds 3 patents. Dr. Peace has been funded by the National Institute of Justice to study the efficacy of electronic cigarettes, particularly as they pertain to substance use and abuse. Dr. Peace serves on the Board for Virginia's Cannabis Control Authority, is a Past President of the Society of Forensic Toxicologists, is a member of The International Association of Forensic Toxicologists and is a Fellow in the American Academy of Forensic Sciences. She is a member of the National Safety Council's Alcohol, Drugs, and Impairment Division.  Dr. Holt is a forensic toxicologist and an Associate Research Faculty member in the Department of Forensic Science at Virginia Commonwealth University. She works within the Laboratory for Forensic Toxicology research where she assists students, maintains instrumentation, and completes casework. Her current research includes characterizing vaping products confiscated from Virginia school students; characterizing cannabis and cannabinoid-products for quality and labeling accuracy; assessing impacts of vaping on alcohol impairment evaluations; and evaluating novel treatments for opioid overdoses. Dr. Holt is an active member of the Society of Forensic Toxicologists, The International Association of Forensic Toxicologists, the American Academy of Forensic Sciences, the International Association of Chemical Testing, and the International Association of Chiefs of Police. Dr. Holt is also a member of the National Safety Council's Alcohol, Drugs, and Impairment Division.   The views and opinions expressed on Awareness 2 Action are those of the guests and host and do not necessarily reflect the official policy or position of the Prevention Department or Northwestern Community Services.

Send us a textDr. Aaron Hartman, MD is a board-certified physician, clinical researcher, and founder of Richmond Integrative & Functional Medicine ( https://richmondfunctionalmedicine.com/ ). Trained in conventional family medicine, Dr. Hartman earned his MD from the Medical College of Virginia and served as a Major in the U.S. Air Force, where he led medical clinics in both the United States and Europe and received additional training in cardiology, dermatology, and nuclear and biological warfare medicine.Over the course of his career, Dr. Hartman has participated in more than 70 clinical trials, published research including work in The Lancet, and cared for patients across four continents in more than 100,000 clinical encounters. He is triple board-certified, with advanced credentials in integrative, functional, metabolic, regenerative, and anti-aging medicine, and he previously served as an Assistant Clinical Professor of Family Medicine at Virginia Commonwealth University.Dr. Hartman's professional focus was profoundly reshaped by a deeply personal experience: adopting his daughter Anna, who was born with severe neurological injury and cerebral palsy and was labeled “incurable” by conventional standards. Her extraordinary progress—achieved through personalized, root-cause, and systems-based approaches to care—became the catalyst for Dr. Hartman's transition into functional and precision medicine.Dr. Hartman is the author of the 2025 book Uncurable ( https://www.amazon.com/UnCurable-Hopeless-Diagnosis-Defying-Odds-ebook/dp/B0FWQ21FDV ), which blends memoir, medical critique, and practical strategy to challenge how modern healthcare defines—and limits—healing. In the book, Dr. Hartman argues that many so-called incurable conditions reflect systemic blind spots rather than biological absolutes, and he calls on patients and clinicians alike to rethink personalized care, patient advocacy, and the foundations of health.Today, Dr. Hartman continues to practice, teach, and research while advocating for a more individualized, curiosity-driven, and human-centered model of medicine—one that treats patients not as protocols, but as complex, exceptional individuals.#AaronHartman #FunctionalMedicine #IntegrativeMedicine #Uncurable #RootCauseMedicine #Nutrigenomics #Neuroplasticity #Rehabilitation #EnvironmentalMedicine #OffLabel #CerebralPalsy #BrainDamage #PersonalizedCare #STEM #Innovation #Science #Technology #Research #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcastSupport the show

Episode 513 / Langdon GravesLangdon Graves is a Virginia-born, New York City-based artist who holds a BFA from Virginia Commonwealth University in Painting & Printmaking and an MFA from Parsons School of Design. She is adjunct faculty at Parsons and Assistant Professor in the Graduate Fine Arts program at Pratt Institute. Langdon has shown her work throughout the United States, Canada, Europe and Australia with solo and group exhibitions that include Dinner Gallery, TEI's Art in Buildings, Mrs., Tilton Gallery, Deanna Evans Projects, Grimm, Taymour Grahne Projects, STONELEAF and the Delaware Contemporary Museum. Langdon has attended the Fountainhead Residency in Miami, the Kunstenaarsinitiatief Residency and Exhibition Program in the Netherlands, the Object Limited residency in Bisbee, Arizona and STONELEAF Retreat in upstate New York. She is a recipient of Canson & Beautiful Decay's Wet Paint Grant and has been featured in Artnet, Art in America, Hyperallergic, Vice Creators Project, Juxtapoz, Art F City, The Wall Street Journal, the Artmatters podcast and Madeline Schwartzman's See Yourself X.

This episode is rated a 5 (on my Serious Crime Scale).After Labor Day weekend in 2005, 17-year-old Taylor Behl returned to the campus of Virginia Commonwealth University eager to resume her freshman year. Away from home for the first time, Taylor was embracing the independence and excitement of college life. But when more than 24 hours passed without anyone hearing from her, concern quickly turned to alarm – and those closest to her knew something was terribly wrong.Listen now to hear the full story. Support this podcast at — https://redcircle.com/campus-crime-chronicles/exclusive-contentAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

#683: Candy now — or a toy later? You slide play money across the table and let your kid choose. That moment kicks off this episode, where Dr. Stephen Day joins us to talk about building a “mini economy” at home.  Dr. Day is the director of the Center for Economic Education at Virginia Commonwealth University. He also holds a PhD in social studies and economics curriculum and instruction. His work looks at how kids form money habits long before they deal with real paychecks, budgets, or credit cards. We break down how a mini economy actually works. Kids have job titles tied to age-appropriate chores. They earn play money. They spend it at a small household store set up on the kitchen table. The store might sell candy, small toys, or privileges like extra screen time. Parents set the prices. Kids decide whether to spend right away or save for something bigger. You hear how this plays out inside Day's own house. A three-year-old takes on the role of “zookeeper,” feeding the cat and picking up stuffed animals. A seven-year-old creates a weekly plan that alternates spending and saving, using patterns she learns at school. A five-year-old chooses to donate part of his earnings instead of spending anything. The system stays the same. The choices vary by kid. The conversation moves through childhood stage by stage. Early years center on routine, structure, and basic trade-offs. Elementary school becomes the key period for practice, when habits and norms take shape. Middle and high school bring longer planning timelines, more independence, and deeper conversations about work, contribution, and goals. We also dig into questions parents ask all the time. Should kids get paid for chores, or should chores come with living in the house? Day explains how families can separate family work, paid jobs, and service work so kids understand why they are doing each task. Clear categories help avoid confusion about motivation and responsibility. Busy schedules come up, too. Sports practices, travel, school events, and late workdays often knock chore systems off track. Day explains how vague expectations create conflict and why job titles and defined duties bring structure even during chaotic weeks. Throughout the episode, the focus stays on practice, not lectures. Kids do not learn money by hearing explanations. They learn by earning, choosing, saving, spending, and living with trade-offs — all inside a system small enough to fit on a kitchen table. Resource: EconEdLink, a CEE program https://econedlink.org Timestamps: Note: Timestamps will vary on individual listening devices based on dynamic advertising run times. The provided timestamps are approximate and may be several minutes off due to changing ad lengths. (00:00) Intro (02:00) Teaching kids money (03:59) Mini economy basics (06:20) Money skills by stages (10:41) Starting at age three (12:02) Cat job example (16:08) Goods versus privileges (17:27) Bugging versus choices (18:11) Paying for chores (20:22) Family job service (24:56) Busy weeks and chores (33:21) Low-consumption kid example (39:17) Shared jobs and teamwork (43:34) Exchange rate to dollars (1:00:28) Investing, 529, compound interest Learn more about your ad choices. Visit podcastchoices.com/adchoices

Pediatric neuropalliative medicine is an emerging area of subspecialty practice that emphasizes the human experience elements of serious neurologic illness. Child neurologists care daily for patients who can benefit from the communication strategies and management practices central to pediatric neuropalliative medicine, whether at the primary or subspecialty level. In this episode, Gordon Smith, MD, FAAN, speaks with Lauren Treat, MD, author of the article "Neuropalliative Medicine in Pediatric Neurology" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Treat is an associate professor in the divisions of child neurology and palliative medicine at the University of Colorado School of Medicine in Aurora, Colorado. Additional Resources Read the article: Neuropalliative Medicine in Pediatric Neurology Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: This is Gordon Smith. Today I've got the great pleasure of interviewing my good friend Dr Lauren Treat about her article on neuropalliative medicine in pediatric neurology practice. This article appears in the December 2025 Continuum issue on neuropalliative care. Lauren, welcome to the Continuum podcast, and maybe you can introduce yourself to our listeners. Dr Treat: Such a delight to be here, Gordon. Thank you. I am a pediatric neurologist and palliative medicine doctor at the University of Colorado, Children's Hospital Colorado, and I am practicing in both areas. I do general child neurology, and I also run a pediatric neuropalliative medicine clinic. So, I'm happy to be here to talk about it. Dr Smith: And, truth in advertising, I tried very hard to get Dr Treat to move to VC to work with me. And I haven't given up yet. I'm looking forward to the conversation. And Lauren, I wonder- one, I'm really excited about this issue, by the way. This is the second podcast I've done. And I'd like to ask the same question I asked of David Oliver, who's amazing. What a great article and conversation we had. And that question is, can you define palliative care? I think a lot of people think of it as, like, end-of-life care or things like that. And is the definition a little different in the pediatric space than it is in the adult space? Dr Treat: Such a great place to start, Gordon. I absolutely think that there are nuances that are very important in pediatrics. And we especially acknowledge in pediatrics that there is a very longitudinal component of this. And even moreso, I think, then in adult neuropalliative medicine, in pediatrics, we are seeing people=even prenatally or early in their first hours and days of life, and walking with them on a journey that might last days or weeks, but might last years or decades. And so, there is this sense that we are going to come alongside them and be part of the ups and the downs. So yes, neuropalliative medicine is a kind of medicine that is a very natural partner to where neurology is in its current field. We're doing a lot of exciting things with modifying diseases, diagnosing things early, and we have a very high reliance on the things that we can measure in medicine. And not all things can be measured that are worthwhile about one's quality of life. A family very poignantly told me very recently, making sure someone stays alive is different from making sure they have a life. And that's what neuropalliative medicine is about. Dr Smith: Well, great summary, and I definitely want to follow up on several aspects of that, but there's one point I was really curious about as I've been thinking about this, you know, these are really exciting times and neurology in general and in child neurology in particular. And we've got all of these exciting new therapies. And as you know, I'm a neuromuscular person, so it's hard not to think back on SMA and not be super excited. And so, I wonder about the impact of these positive developments on the practice of neuropalliative care in kids. You know, I'm just thinking, you know, you mentioned it's a journey with ups and downs. And I wonder, the complexity of that must be really interesting. And I bet your job looks different now than it did seven or eight years ago. Dr Treat: That's absolutely true. I will self-reference here one of the figures in the paper. Figure 2 in my section is about those trajectories, about how these journeys can have lots of ups and downs and whether this person had a normal health status to begin with or whether they started out life with a lot of challenges. Those ups and downs inherently involve a lot of uncertainty. And that's where palliative medicine shines. Not because we have the answer---everyone would love for us to have the answer---but because we consider ourselves uncertainty specialists in the way that we have to figure out what do we know, what can we ground ourselves in, and how can we continue to move forward even if we don't have all the answers? That is a particular aspect of neurology that is incredibly challenging for families and clinicians, and it can't stand as a barrier to moving forward and trying to figure out what's best for this child, what's best for this family. What do we know to be true about them as people, and how can we integrate that with all of the quantitative measures that we know and love in neurology? Dr Smith: So, I love the comment about prognostication, and this really ties into positive uncertainty or negative undercertainty in terms of therapeutic development. I wonder if you can talk a little bit about your approach to prognostication, particularly in a highly fluid situation. And are there pearls and pitfalls that our listeners should consider when they're discussing prognosis for children, particularly maybe young children who have severe neurological problems? Dr Treat: It's such a pivotal issue, a central issue, to child neurology practice. Again, because we are often meeting people very, very early on in their journey---earlier than we ever have before, sometimes, because of this opportunity to have a diagnosis, you know, prenatally or genetically or whatever else it is---sometimes we are seeing the very early signs of something as compared to previously where we wouldn't have a diagnosis until something was in its more kind of full-blown state. This idea of having a spectrum and giving people the range of possible outcomes is absolutely still what we need to do. However, we need to add on another skill on top of that in helping people anchor into what feels like the most likely situation and what the milestones are going to be in the near future, about how we're going to walk this journey and what we'll be on the lookout for that will help us branch into those different areas of the map down the road. Dr Smith: So, I wonder if we can go back to the framework you mentioned, two answers ago, I think? You and the article, you know, provide four different types of situations kind of based on temporal progression. I wonder if maybe the best way of approaching is to give an example and how that impacts your thoughts of how you manage a particular situation. Dr Treat: Absolutely. So, this figure in particular is helpful in multiple ways. One is to just give a visual of what these disease trajectories are doing, because we're doing that when and we take a history from a patient. But actually, to put it into an external visual for yourself, for your team, but also perhaps for the family can be really powerful. It helps you contextualize the episode of care in which you're meeting the family right now. And it also helps, sometimes, provide some sense of alignment or point out some discrepancies about how you're viewing that child's health and quality of life as compared to how the family might be viewing it. And so, if you say, you know, it sounds like during those five years before we met, you were up here, and now we find ourselves down here, and we're kind of in the middle of the range of where I've seen this person's health status be. Do I have that right? Families feel really seen when you do that and when you can get it accurately. And it also invites a dialogue between the two parties to be able to say, well, maybe I would adjust this. I think we had good health or good quality of life in this season. But you're right, it's getting harder. It's kind of that "show, don't tell" approach of bringing together all the facts to put together the relative position of where we are now in the context of everything they've been through. Dr Smith: You know, I wonder if you could talk a little bit more about the differences between palliative care and adult patients and in children? Dr Treat: Absolutely. One of the key features in pediatrics is this kind of overriding sense of an out-of-order event in the family's life. Children are not supposed to have illness. Children are not supposed to have disability. Children are not supposed to die before their parents. And that layer of tragedy is incredibly heavy and pervasive. It's not every encounter that you have in child neurology, but it does kind of permeate some of the conversations that neurologists have with their patients, especially patients who have serious neurological disease. So that could be things like epileptic encephalopathies, birth injuries, other traumatic brain injuries down the line. In the paper, I'd go through many different categories of the types of conditions that are eligible for pediatric neuropalliative medicine, that kind of support. When we think about that layer of tragedy in the relation to where we're meeting these families, they deserve extra support, not just to think about the medicines and the treatments, but also, what can we hope for? How can we give this child the best possible life in whatever circumstance that they're in? How can we show up in whatever medical decision-making circumstances present themselves to us and feel like we've done right by this child? It's a complex task, and pediatric neural palliative medicine is evolving to be able to be in those spaces with families in a very meaningful way. Dr Smith: So, of course, one of the differences is the, you know, very important role of parents in the situation, right? Obviously, parents are involved in adult palliative care issues and family is very important. But I wonder if you can talk about specific considerations given the parent-child relationship? Dr Treat: So, pediatric neuropalliative medicine really helps facilitate discussions not just about, again, those things that we have data on, but also about what is meaningful and foundational for those families. What's possible at home, what's possible in the community. In pediatrics, parents are making decisions on behalf of their child, often as a dyad, and I don't think this gets enough attention. We know from adult literature that making decisions on behalf of someone else is different from making decisions on behalf of oneself. We call this proxy decision-making. And proxies are more likely to be conservative on behalf of someone else than they are on behalf of themselves, and they're also more likely to overestimate the tolerability of a medical intervention. So, they might say, I wouldn't want this, or, I wouldn't accept this risk on behalf of myself, or, I don't think I'd want to have to persevere through something, but on behalf of this other person, I think they can do it or I will help them through it or something else like this, or, I can't accept the risk on behalf of them. So that's not good or bad. That's just different about making a decision on behalf of oneself as compared to making a decision on behalf of someone else. When there's two people trying to be proxies on behalf of a third person, on behalf of a child, that's a really, really complex task, and it deserves support. And so, pediatric neural palliative medicine can function, then, as this neutral space, as this kind of almost coaching opportunity alongside the other medical doctors to give parents an opportunity when their minds are calm---not in the heat of the moment---to talk about how they see their child, how they've shown up themselves, what they've seen go well, what they've struggled with. And how,, then we can feel prepared for future decision making times, future high-stress encounters, about what will be important to ground them in those moments, even though we can't predict fully what those circumstances might be. Dr Smith: It sounds, you know, from talking to you and having read the article, that these sorts of issues evolve over time, right? And you have commented on this already from your very first answer. And you do describe a framework for how parents think---their mental model, I guess---of, you know, a child with a serious illness. And this sounds like appreciation of that's really important in providing care. Maybe you can talk us through that topic? Dr Treat: I refer to this concept of prognostic awareness in all of the conversations that we have with families. So, what I mean by prognostic awareness is the degree of insight that an individual has about what's currently happening with their child and what may happen in the future regarding the disease and/or the complications. And when we meet people early on in their journey, often their prognostic awareness, that sense of insight about what's going on, can be limited because it requires lived experience to build. Oftentimes time is a factor in that, we gain more lived experience over time, but it's not just time that goes into building that. It's often having a child who has a complication. Sometimes it's experiencing a hospitalization. That transfer from a cognitive understanding of what's going on, from a lived experience about what's going on, really amplifies that prognostic awareness, and it changes season by season in terms of what that family is going through and what they're willing to tolerate. Dr Smith: You introduced a new term for me, which is hyper-capableism. Can you talk about that? I found that really interesting and, you know, it reminds me a lot of the epiphanies that we've had about coma and coma prognosis. So, what's hyper-capableism? Dr Treat: Yes. In neurology, we have to be very aware of our views on ableism, on understanding how we prognosticate in relation to what we value about our abilities. And hyper-capableism refers to someone who feels very competent both cognitively and from a motor standpoint and fosters that sense of value around those two aspects to a high degree. I'm referencing that in the article with regard to medicine, because medicine, the rigors of training, the rigors of practice, require that someone has mental and motor fortitude. That neurology practice and medical practice in general can breed this attitude around the value of skills in both of those areas. And we have to be careful in order to give our patients and families the best care, to not overly project our values and our sense of what's good and bad in the world regarding ableism. Impairments can look different in different social contexts. And when the social context doesn't support an impairment, that's where people struggle. That's where people have stigma. And I think there's a lot of work that we can do in society at large to help improve accommodations for impairment so that we have less ableism in society. Dr Smith: Another term that I found really interesting kind of going back to parents is the "good parent identity." Maybe you can talk about that? Dr Treat: Good parent identity, good parent narrative, is something that is inherent to the journey when you're trying to take care of and make decisions on behalf of a child. And whether you're in a medical context or outside of a medical context, all parents have this either explicit or implicit sense of themselves about what it means to do right by their child. This comes up very poignantly in complex medical conditions because there are so many narratives about what parents ought to do on behalf of their child, and some of those roles can be in tension with one another. It's a whole lot of verbs that often fall under that identity. It's about being able to love and support and take good care of and make good decisions on behalf of someone. But it's also about protecting them from harm and treating their pain and being able to respond to them and know their cues and know these details about them. And you can't, sometimes, do multiple of those things at once. You can't give them as much safety and health as possible and also protect them from pain and suffering when they have a serious illness, when they need care in the hospital that might require a treatment that might be invasive or burdensome to them. And so, trying to be a good parent in the face of not being able to fulfill all those different verbs or ideas about what a good parent might do is a big task. And it can help to make it an explicit part of the conversation about what that family feels like their good parent roles might be in a particular situation. Dr Smith: I want to shift a little bit, Lauren, that's a really great answer. And just, you know, listening to you, your language and your tongue is incredibly positive, which is exciting. But, you know, you have talked about up and downs, and I wanted you to comment on a quote. I actually wrote it down, I'm going to read it to you, because you mentioned this early on in your article: "the heavy emotional and psychological impacts of bearing witness to suffering as a child neurologist." I think all of us, no matter how excited we are about all the therapeutic development, see patients who are suffering. And it's hard when it's a child and you're seeing a family. I wonder if you could talk a little bit about that comment and how you balance that. You're clearly- you're energized in your career, but you do have to bear witness to suffering. Dr Treat: You're right. Child neurologists do incredible work, it's an incredible, exciting field, and there are a lot of challenges that we see people face. And we see it impacts their lives in really intense ways over the course of time. We bear witness to marriages that fall apart. We bear witness to families that lose jobs or have to transition big pieces of their identity in order to care for their children. And that impacts us. And we hold the collective weight of the things that we are trying to improve but sometimes feel less efficacious than we hoped that we could around some of these aspects of people's lives. And so, pediatric neuropalliative medicine is also about supporting colleagues and being able to talk to colleagues about how the care of the patients and the really real effort that we exert on their behalf and the caring that we have in our hearts for them, how that matters. Even if the outcome doesn't change, it's something that matters for our work and for our connections with these families. It's really important. Dr Smith: I wonder, maybe we can end by learning a little bit about your journey? And maybe this is your opportunity to- I know we have students and residents who listen to us, and junior faculty. I think neuropalliative care is obviously an important issue. There's a whole Continuum issue on it---no pun intended---but what was your journey, and maybe what's your pitch? Dr Treat: I'm just going to give a little bit of a snippet from a poem by Andrea Gibson, who's a poet, that I think speaks really clearly to this. They say a difficult life is not less worth living than a gentle one. Joy is simply easier to carry than sorrow. I think that sums these things up really well, that we find a lot of meaning in the work that we do. And it's not that it's easier or harder, it's just that these things all matter. I'm going to speak now, Gordon, to your question about how I got to my journey. When I went into pediatrics and then neuro in my training, I have always loved the brain. It's always been so crucial to what I wanted to do and how I wanted to be in the world. And when I was in my training, I saw that a lot of the really impactful conversations that we were having felt like we left something out. It felt like we couldn't talk about some of the anticipated struggles that we would anticipate on a human level. We could talk about the rate and the volume of the G tube, but we couldn't talk about how this was going to impact a mother's sense of being able to nourish and bond and care for their child because we didn't have answers for those things. And as I went on in my journey, I realized that even if we don't have answers, it's still important for us to acknowledge those things and talk about them and be there for our patients in those conversations. Dr Smith: Well, Lauren, what a great way to end, and what a wonderful conversation, and what a great article. Congratulations and thank you. Dr Treat: Thank you, Gordon. It was a pleasure to be here. Dr Smith: Again today, I've been interviewing Dr Lauren Treat about her really great article on neuropalliative medicine in pediatric neurology practice. This article appears in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this issue and other issues. And thanks again to you, our listeners, for joining us today. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Historian Brooke Newman discusses with Ivan six things which should be better known. Dr. Brooke Newman is an Associate Professor at Virginia Commonwealth University and a Fellow of the Royal Historical Society. She specializes in the history of early modern Britain and the British Atlantic, with a focus on slavery and its legacies. She is the author of the award-winning book, A Dark Inheritance: Blood, Race, and Sex in Colonial Jamaica (Yale, 2018), and The Crown's Silence: The Hidden History of Slavery and the British Monarchy (Mudlark, 2026), which is available at https://harpercollins.co.uk/products/the-crowns-silence-the-hidden-history-of-slavery-and-the-british-monarchy-brooke-newman?variant=55509554397563. Her writing and research have been featured in the Guardian, the Washington Post, Der Spiegel, and Smithsonian Magazine, and she has served as a historical expert for HBO's Last Week Tonight, Vox, the BBC, and NPR, among others. The difference between historians and journalists https://www.historians.org/perspectives-article/journalists-and-historians-april-2023/ What it's like to work in an archive https://www.wessexarch.co.uk/news/day-life-ofan-archivist The value and limitations of archives https://slimkm.com/blog/advantages-and-limitations-of-archival-research/ The Stuart monarchs launched England into the transatlantic slave trade https://www.historyanswers.co.uk/kings-queens/royal-african-company-how-the-stuarts-birthed-britains-slave-trade/ The South Sea Company was not just a Ponzi scheme https://www.historic-uk.com/HistoryUK/HistoryofEngland/South-Sea-Bubble/ Formerly enslaved people appealed directly to the Royal Family to abolish the slave trade https://www.theguardian.com/commentisfree/2023/apr/06/british-monarchy-ties-slavery-historical-archives-slaves This podcast is powered by ZenCast.fm

This is episode 808. Read the complete transcription on the Sales Game Changers Podcast website here. This is a special episode of the "Office Hours - Sales Professors Unplugged Podcast." The show feature interviews with sales professors at universities with a sales excellence programs. Many of the universities are members of the University Sales Center Alliance. Watch the interview on YouTube here. The Sales Game Changers Podcast was recognized by YesWare as the top sales podcast. Read the announcement here. FeedSpot named the Sales Game Changers Podcast at a top 20 Sales Podcast and top 8 Sales Leadership Podcast! Subscribe to the Sales Game Changers Podcast now on Apple Podcasts! Purchase Fred Diamond's best-sellers Love, Hope, Lyme: What Family Members, Partners, and Friends Who Love a Chronic Lyme Survivor Need to Know and Insights for Sales Game Changers now! Today's show is a special "Office Hours - Sales Professors Unplugged" episode featuring Andy McGowan, Director, Center for Professional Selling at Virginia Commonwealth University. Find Andy on LinkedIn. Andy's TIP: "The best sales professionals never stop training; the moment you think you're done learning is the moment you start falling behind."

Dr. Stephen Day--author of Teach a Kid to Save: A Fun, Hands-On Approach to Building Smart Money Habits--joins the show today. The book offers a hands-on, research-based guide to teaching your kids about the wise use of money and the value of work through an innovative, interactive mini-economy where kids have jobs, earn a play-money income, make a plan for their money, shop at the household store, and even create their own businesses. Teach a Kid to Save includes lessons on rest, generosity, saving and spending as well as a quick-start guide, templates, visual aids, conversation starters, and a special appendix for homeschools. Dr. Day also shares how fatherhood inspired the book and how he views money through a biblical lens. Dr. Day is a term associate professor at the Virginia Commonwealth University (VCU) School of Business, director of the VCU Center for Economic Education, and chairperson of the Virginia Jump$tart Coalition for Personal Financial Literacy. He has helped hundreds of teachers create mini-economies in their classrooms. Follow Dr. Stephen Day here: drstephenday.comSubstack: Paper Robots: Helping Families Talk About Money and WorkInstagram: _paperrobots Sports clips:Rick Tocchet (Philadelphia Flyers head coach) (Flyers YouTube)Nick Nurse (Philadelphia 76ers head coach) (76ers YouTube)See omnystudio.com/listener for privacy information.

John Mlynczak is the President and CEO of NAMM, where he leads the world's largest music products trade association at a pivotal moment in its 125-year history. Appointed in 2023 as the industry emerged from the COVID era, John has focused on evolving the NAMM Show through a relationship-first, technology-driven approach that strengthens year-round engagement and meaningful connections for members and exhibitors.A lifelong musician, educator, and technology leader, John brings a rare blend of creative empathy and strategic vision to his role. Prior to NAMM, he served as Vice President of Music Education & Technology at Hal Leonard, overseeing global education strategy and leading platforms such as Noteflight and Essential Elements Interactive. Earlier in his career, he was Director of Education at PreSonus Audio, where he helped shape curriculum, products, and outreach for music education technology.John has spent many years in higher education as an adjunct professor at institutions including VanderCook College of Music, Louisiana State University, and the University of Louisiana at Lafayette, while also serving as President of the Technology Institute for Music Education (TI:ME). He is a Google Level 2 Certified Educator, a frequent speaker on music education and advocacy, and has served on numerous national committees supporting arts education.As a performer, John is an accomplished trumpeter with experience ranging from orchestral and pit work to jazz and contemporary ensembles. He holds a Bachelor of Music Education from Virginia Commonwealth University and Master's degrees in Music Performance and Education Leadership from Louisiana State University.At the core of his leadership philosophy is a belief that technology should enhance - not replace - human connection, and that relationships remain the most powerful force in the music industry.This Episode is brought to you by ETC and Main Light

Today we're talking about direct restorative materials that can truly change the course of your patients' dental health — and no, not just composite, but glass ionomer and resin-modified glass ionomer. Used strategically, these materials can help patients avoid a lifetime of fillings, crowns, and repeat dental work. And adopting this conservative approach doesn't mean sacrificing revenue — in fact, building a practice focused on preserving healthy tooth structure attracts patients who value care that's truly in their best interest. Joining us is Dr. Brian Nový, a leading cariologist at Virginia Commonwealth University with faculty appointments at Harvard and Western University, and a private practice owner in Salem, Massachusetts. He'll explain how glass ionomer and RMGI bond to teeth, their clinical applications, address concerns about strength and aesthetics, and show how they can transform long-term patient outcomes.

Former UGA Player of the Year and Utah Tech horse beast Zach Felts Zach Felts returns home from Virginia Commonwealth University for the holidays and wins the Coral Canyon Amateur. Felts joins the pod. Sponsored by Goldenwest Credit Union. 

Donny Lind is the Men's Basketball Head Coach at Mount St. Mary's University. In his first season, the 2024-25 team captured the university's first Metro Atlantic Athletic Conference (MAAC) championship with a victory over Iona in the conference title game. They would notch a NCAA Tournament victory - the program's third - by defeating American in the First Four. The 23 wins by the team set a Division I record and were the most by any Mount St. Mary's squad since 1986-87.Lind previously served on coaching staffs at both Radford and UNCG under head coach Mike Jones from 2016 - 2024In his first stint at the Mount from 2013 – 2016 he was as an assistant coach and recruiting coordinator and was on staff for the team's 2014 Northeast Conference Championship.Former Mount Head Coach Jamion Christian brought Lind along from Virginia Commonwealth University where he worked as a graduate manager before being elevated to video coordinator. He was part of the Rams' storied run as the team won 84 games, including seven NCAA Tournament games and the team's run to the 2011 Final Four.On this episode Mike and Donny discuss the importance of fostering relationships in the realm of coaching. Lind shares how aiding the personal growth of both his players and staff is critical to his success. In this discussion, we delve into the intricate dynamics of cultivating a competitive culture within the team, a necessity for achieving success. Lind reflects on his journey, from his upbringing in a basketball-centric environment to his evolution as a coach, underscoring the significance of resilience and adaptability in the face of challenges. Through a serious examination of the modern landscape of college athletics, he articulates how he seeks to impact his players within the limited time frame afforded by today's NIL and transfer portal environment.Follow us on Twitter and Instagram @hoopheadspod for the latest updates on episodes, guests, and events from the Hoop Heads Pod.Make sure you're subscribed to the Hoop Heads Pod on Spotify or wherever you get your podcasts and while you're there please leave us a 5 star rating and review. Your ratings help your friends and coaching colleagues find the show. If you really love what you're hearing recommend the Hoop Heads Pod to someone and get them to join you as a part of Hoop Heads Nation.Grab pen and paper before you listen to this episode with Donny Lind, Men's Basketball Head Coach at Mount St. Mary's University.Website - https://mountathletics.com/sports/mens-basketballEmail - donny.lind@gmail.comTwitter/X - @dslindVisit our Sponsors!Dr. Dish BasketballA Perfect Gift To Your Team for the Holidays!Score Big on Dr. Dish Basketball's End of Year Sale and give your team the gift of extra, more efficient reps this season!

Universities have been trying to curb dangerous binge drinking for years. Today's students are glued to their phones, and Abby Braitman (Old Dominion University) and her colleagues are meeting them where they are for interventions. And: Meagan Brem (Virginia Tech) says that drinking is intertwined with a lot of the intimate partner violence that happens on college campuses. Later in the show: There's a psychedelic renaissance going on in Javier González-Maeso's (Virginia Commonwealth University) biochemistry lab. He's hoping to develop a new drug using psilocybin, the component found in magic mushrooms, to help people battling alcohol abuse disorder. Plus: How Jasmohan Bajaj (Virginia Commonwealth University) discovered that addiction lives in the gut, not the mind.

Careful assessment and individualized care, provided by a skilled multidisciplinary care team, are emphasized in the holistic approach to neuropalliative care, which considers physical, psychological, social, spiritual, and existential aspects for people with neuromuscular diseases. In this episode, Gordon Smith, MD, FAAN, speaks with David J. Oliver, PhD, FRCP, FRCGP, FEAN, author of the article "Neuropalliative Care in Neuromuscular Disorders" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Oliver is an honorary professor of Tizard Centre at the University of Kent in Canterbury, United Kingdom. Additional Resources Read the article: Neuropalliative Care in Neuromuscular Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: Hello, this is Dr Gordon Smith. Today I've got the great pleasure of interviewing Dr David Oliver about his article on neuropalliative care and neuromuscular disorders, which appears in the December 2025 Continuum issue on neuropalliative care. David, welcome to the Continuum podcast, and please introduce yourself to our audience. Dr Oliver: Thank you. It's a pleasure and a privilege to be here. I'm a retired consultant in palliative medicine in the UK. I worked at the Wisdom Hospice in Rochester for over thirty years, and I'm also an honorary professor at the University of Kent in Canterbury in the UK. I've had a long interest in palliative care in neurological diseases. Hopefully we can talk about a bit later. Dr Smith: I really look forward to learning a little bit more about your path and experiences. But I wonder if, before we get into the meat of neuropalliative care with a focus on neuromuscular, if maybe you can kind of set the stage by just defining palliative care. I mean, my experience is that people think of this in different ways, and a lot of folks think- hear palliative care, and they immediately go to end-of-life care or comfort care. So, what- how should we think about maybe the discipline of palliative care or neuropalliative care? Dr Oliver: I see palliative care as very much responding to people's needs, whether that's physical needs, psychological needs, social or spiritual or existential. So, it can be much earlier in the disease progression. And I think particularly for neurological diseases, early involvement may be very important. Dr Smith: That was actually going to be my first substantive question, really, was when to begin the conversation and what does that look like and how does it evolve over time. You have a really great figure in the article that kind of emphasizes the various stages within a patient's journey that, you know, palliative care can become involved. But I wonder if you could use ALS as a good example and describe what that looks like from when a patient is first diagnosed with ALS through their course? Dr Oliver: I think particularly in ALS at the beginning, soon after diagnosis, someone may have a lot of distress and a lot of questions that they need answering. This is a disease they've not had any contact with before. And they don't understand what's going on, they don't understand the disease. So, there may be a great need to have the opportunity to talk about the disease, what may happen, what is happening, how it's going to affect them and their family. As think time goes on, there may be later they develop swallowing problems, and that will need to be talking about a feeding tube and gastrostomy. And again, there may be a lot of issues for the person and their family. As they deteriorate, they may have respiratory problems and need to have discussion about ventilatory support, either by PAP, noninvasive ventilation, or even tracheostomy. And again, I think that's a big issue that needs wide discussion. And then it may be at the final few months of the disease, where they are deteriorating, that they may have increased needs, and their families may have those needs after the death. And I think often families bereaved from someone with a neurological disease such as ALS need a great deal of support, having many mixed emotions. There may be a feeling of relief that they're not involved in that caring, but then a feeling of guilt that they shouldn't be having those feelings. So, I think that can happen over a period of… what with ALS it may be two, three, four years, but it may be similar changes over time with any patient with a neurological disease. It may be ten or fifteen years with Parkinson's or five to ten years with a progressive supranuclear palsy, but there'll be this similar need to look at palliative care during their disease progression. Dr Smith: So, I'm curious at the time of diagnosis of ALS, how far out in the future do you provide information? So a specific question would be, do you talk about end-of-life management? In my experience, ALS patients are sometimes interested in knowing about that. Or do you really focus on what's in front of you in the next three to six months, for instance? Dr Oliver: I think it's both. Obviously, we need to talk about the next three to six months, but often giving patients the opportunity to talk about what's going to happen in the future, what may happen at the end of life, I think is important. And I think a disease like ALS, if they look it up on the Internet, they may have a lot of very distressing entries there. There's a lot about how distressing dying with ALS is. And actually confront those and discuss those issues early is really important. Dr Smith: So of course, the other thing that comes up immediately with an ALS diagnosis---or, for that matter, with any other neurodegenerative problem---is prognosis. Do you have guidance and how our listeners who are giving a diagnosis of ALS or similar disorder should approach the prognostication discussion? Dr Oliver: It's often very difficult. Certainly in the UK, people may have- be a year into their disease from their first symptoms before they're diagnosed, and I've seen figures, that's similar across the world. So, people may be actually quite way through their disease progression, but I do think we have to remember that the figures show that at five years, 25% of people are still alive, and 5 to 10% are still alive at ten years. We mustn't say you are going to die in the next two or three years, because that may not be so. And I think to have the vagueness but also the opportunity to talk, that we are talking of a deterioration over time and we don't know how that will be for you. I always stress how individual I think ALS is for patients. Dr Smith: One of the other concepts that is familiar with anyone who does ALS and clearly comes through in your article---which is really outstanding, by the way. So, thank you and congratulations for that---is the importance of multidisciplinary teams. Can you talk a little bit about how neuropalliative care sits within a multidisciplinary care model? Dr Oliver: I think the care should be multidisciplinary. Certainly in the UK, we recommended multidisciplinary team care for ALS in particular, from the time of diagnosis. And I think palliative care should be part of that multidisciplinary team. It may be a member of the team who has that palliative care experience or someone with specialist experience. Because I think the important thing is that everyone caring for someone with ALS or other neuromuscular diseases should be providing palliative care to some extent: listening to people, discussing their goals, managing their symptoms. And a specialist may only be needed if those are more complicated or particularly difficult. So, I think it is that the team needs to work together to support people and their families. So, looking at the physical aspects where the physiotherapist or occupational therapist may be very important, the psychologicals are a counsellor or psychologist. The social aspects, most of our patients are part of wider families, and we need to be looking at supporting their carers and within their family as well as the person. And so that may involve social work and other professionals. And the spiritual, the why me, their fears about the future, may involve a spiritual counsellor or a chaplain or, if appropriate, a religious leader appropriate to that- for that person. So, I think it is that wider care provided by the team. Dr Smith: I'm just reflecting on, again, your earlier answers about the Continuum of neuropalliative care. Knowing your patient is super valuable here. So, having come to know someone through their disease course must pay dividends as you get to some of these harder questions that come up later during the disease progression. Dr Oliver: I think that's the very important use of palliative care from early on in the diagnosis. It's much easier to talk about, perhaps, the existential fears of someone while they can still talk openly. To do that through a communication aid can be very difficult. To talk about someone's fear of death through a communication aid is really very, very difficult. The multidisciplinary team, I think, works well if all the members are talking together. So that perhaps the speech therapist has been to see someone and has noticed their breathing is more difficult, comes back and talks to the doctor and the physiotherapist. The social worker notices the speech is more difficult and comes back and speaks to the speech therapist. So, I think that sort of team where people are working very closely together can really optimize the care. And as you said, knowing the person, and for them to know you and to trust you, I think that's important. Those first times that people meet is so important in establishing trust. And if you only meet people when they're very disabled and perhaps not able to communicate very easily, that's really difficult. Dr Smith: I think you're reading my mind, actually, because I was really interested in talking about communication. And you mentioned a few times in your article about voice banking, which is likely to be a new concept for many of our listeners. And I would imagine the spectrum of tools that are becoming available for augmented communication for patients who have ALS or other disorders that impair speech must be impressive. I wonder if you could give us an update on what the state of the art is in terms of approaching communication. Dr Oliver: Well, I think we all remember Stephen Hawking, the professor from Cambridge, who had a very robotic voice which wasn't his. Now people may have their own voice on a communication aid. I think the use of whether it's a mobile phone or iPad, other computer systems, can actually turn what someone types into their own voice. And voice banking is much easier than it used to be. Only a few years ago, someone would have to read for an hour or two hours so the computer could pick up all the different aspects of their voice. Now it's a few minutes. And it has been even- I've known that people have taken their answer phone off a telephone and used that to produce a voice that is very, very near to the person. So that when someone does type out, the voice that comes out will be very similar to their own. I remember one video of someone who'd done this and they called their dog, and the dog just jumped into the air when he suddenly heard his master's voice for the first time in several months. So, I think it's very dramatic and very helpful for the person, who no longer feels a robot, but also for their family that can recognize their father, their husband, their wife's speech again. Dr Smith: Very humanizing, isn't it? Dr Oliver: There is a stigma of having the robotic voice. And if we can remove that stigma and someone can feel more normal, that would be our aim. Dr Smith: As you've alluded to, and for the large majority---really all of our ALS patients, barring something unexpected---we end up in preparing for death and preparing for end of life. I wonder what advice you have in that process, managing fear of death and working with our patients as they approach the end of their journey. Dr Oliver: I think the most important thing is listening and trying to find what their particular concerns are. And as I said earlier, they may have understood from what they've read in books or the Internet that the death from ALS is very distressing. However, I think we can say there are several studies now from various countries where people have looked at what happens at the end of life for people with ALS. Choking to death, being very distressed, are very, very rare if the symptoms are managed effectively beforehand, preparations are made so that perhaps medication can be given quickly if someone does develop some distress so that it doesn't become a distressing crisis. So, I think we can say that distress at the end of life with ALS is unusual, and probably no different to any other disease group. It's important to make sure that people realize that with good symptom control, with good palliative care, there is a very small risk of choking or of great distress at the end of life. Dr Smith: Now, I would imagine many patients have multiple different types of fear of death; one, process, what's the pain and experience going to be like? But there's also being dead, you know, fear of the end of life. And then this gets into comments you made earlier about spirituality and psychology. How do you- what's your experience in handling that? Because that's a harder problem, it seems, to really provide concrete advice about. Dr Oliver: Yeah. And so, I think it's always important to know when someone says they're frightened of the future, to check whether it is the dying process or after death. I've got no answer for what's going to happen afterwards, but I can listen to what someone may have in their past, their concerns, their experience. You know, is their experience of someone dying their memories of someone screaming in pain in an upstairs bedroom while they were a child? Was their grandfather died? Trying to find out what particular things may be really a problem to them and that we can try and address. But others, we can't answer what's going to happen after death. If someone is particularly wanting to look at that, I think that may be involving a spiritual advisor or their local spiritual/religious leader. But often I think it's just listening and understanding where they are. Dr Smith: So, you brought up bereavement earlier and you discussed it in the article. In my experience is that oftentimes the families are very, very impacted by the journey of ALS. And while ALS patients are remarkably resilient, it's a huge burden on family, loved ones, and their community. Can you talk a bit about the role of palliative care in the bereavement process, maybe preparing for bereavement and then after the loss of their loved one? Dr Oliver: Throughout the disease progression, we need to be supporting the carers as much as we are the patient. They are very much involved. As you said, the burden of care may be quite profound and very difficult for them. So, it's listening, supporting them, finding out what their particular concerns are. Are they frightened about what's going to happen at the end of life as well? Are they concerned of how they're going to cope or how the person's going to cope? And then after the death, it's allowing them to talk about what's happened and how they are feeling now, cause I think having had that enormous input in care, then suddenly everything stops. And also, the support systems they've had for perhaps months of the carers coming in, the doctor, the nurse, the physiotherapist, everyone coming in, they all stop coming. So, their whole social system suddenly stops and becomes much reduced. And I'm afraid certainly in the UK if someone is bereaved, they may not have the contact with their friends and family because they're afraid to come and see them. So, they may become quite isolated and reduced in what they can do. So, I think it's allowing them to discuss what has happened. And I think that's as important sometimes for members of the multidisciplinary team, because we as doctors, nurses and the wider team will also have some aspects of bereavement as we face not seeing that person who we've looked after for many years and perhaps in quite an intensive way. So, we need to be looking at how we support ourselves. And I think that's another important role of the multidisciplinary team. I always remember in our team, sometimes I would say, I find this person really difficult to cope with. And the rest of the people around the team would go have a sigh of relief because they felt the same, but they didn't like to say. And once we could talk about it, we could support each other and work out what we could do to help us help the patient in the most effective way. Dr Smith: Well, David, I think that's a great point to end on. I think you've done a really great job of capturing why someone would want to be a palliative care specialist or be involved in palliative care, because one of the themes throughout this conversation is the very significant personal and care impact that you have on patients and families. So, I really appreciate your sharing your wisdom. I really encourage all of our listeners to check out the article, it's really outstanding. I wonder if maybe you might just briefly tell us a little bit about how you got into this space? It's obviously one for which you have a great deal of passion and wisdom. How did you end up where you are? Dr Oliver: I became interested in palliative care as a medical student, and actually I trained as a family doctor, but I went to Saint Christopher's Hospice following that. I had actually had contact with them while I was a medical student, so I worked Saint Christopher's Hospice in South London when Dame Cecily Saunders was still working there. And at that time Christopher's had sixty-two beds, and at least eight of those beds were reserved for people with ALS or other neurological diseases. And I became very involved in one or two patients and their care. And Dame Sicily Saunders asked me to write something on ALS for their bookshelf that they had on the education area. So, I wrote, I think, four drafts. I went from sort of C minus to just about passable on the fourth draft. And that became my big interest in particularly ALS, and as time went on, in other neurological diseases. When I went to the Wisdom Hospice as a consultant, I was very keen to carry on looking after people with ALS, and we involved ourselves with other neurological patients. That's how I got started. Having that interest, listening to patients, documenting what we did became important as a way of showing how palliative care could have a big role in neurological disease. And over the years, I've been pressing again and again for the early involvement of palliative care in neurological diseases. And I think that is so important so that there can be a proper holistic assessment of people, that they can build up the trust in their carers and in the multidisciplinary team so that they can live as positively as possible. And as a result of that, that their death will be without distress and with their family with them. Dr Smith: Well, David, you've convinced and inspired me, and I'm confident you have our listeners as well. Thank you so much for a really informative, enjoyable, inspiring conversation. Dr Oliver: Thank you for inviting me. Dr Smith: Again, today I've been interviewing Dr David Oliver about his article on neuropalliative care and neuromuscular disorders, which appears in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this and other issues, and thanks to our listeners for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

photo by Janna Tew Sophie Haulman is a Brooklyn-based ceramicist and sculptor from Wilmington, North Carolina. She received her BFA (2019) from Virginia Commonwealth University's department of Sculpture + Extended Media. While maintaining her practice, she is also a ceramics teacher and works in ceramic production and fabrication. Her evolving work explores the sensuality of space, the body and the unknown through material-based experimentation, contemplation on process, investigation of tactile form, and a constant surrender to fate.   “every month grass came” is a contemplation on mortality and the temporary nature of all that we possess – our bodies, relationships, experiences, memories, desires. As beings of the natural world, we evolve, erode, disintegrate; how do we construct a coherent sense of identity from an existence that is ever-changing?  These ceramic works question and explore these themes of impermanence, loss, and the unknown through a material which has the capacity to long outlast our own bodies while bearing moments of our time within it. Its physical fragility but potential for permanence challenges the transitory nature of self. Sophie Haulman reflects on the idea of resiliency as crucial to surviving one's evolution.  Haulman's work is just as much about the labor and fate of process as it is about the result, considering “process” as both an action and a passage of time. Each piece was handbuilt with slow, methodical, repetitive movements encapsulated within the material body, resulting in forms that question themselves and occlude the transformations of their identities.  The title and show are dedicated to Steffan Elijah Haulman, the artist's deceased brother. His photo, seen daily on the side of her refrigerator, is held up by four contemplative word magnets that have become a kind of mantra: every | month | grass | came.  Sophie Haulman reckon with, or memento mori 2, 2025 Ceramic, glaze 60 × 60 × 3/4 in 152.4 × 152.4 × 1.9 cm. photo by Sophie Haulman Sophie Haulman, the well, or memento mori 1, 2025 Ceramic, glaze 13 1/2 × 19 1/2 × 19 1/2 in 34.3 × 49.5 × 49.5 cm, photo by Janna Tew Left to Right – Sophie Haulman Untitled 2, 2025 Ceramic 18 × 8 × 10 in 45.7 × 20.3 × 25.4 cm, Untitled 1, 2025 Ceramic 18 × 8 × 9 in 45.7 × 20.3 × 22.9 cm. photo by Sophie Haulman

From her Mayberry‑like childhood in rural Virginia to pioneering MRCP and leading one of the nation's largest academic radiology departments, Ann S. Fulcher, MD, Chair of Radiology at Virginia Commonwealth University, has built a career defined by service, integrity, and curiosity. In this episode, she sits down with host Geoffrey Rubin, MD, MBA, FACR, for a warm and deeply personal conversation tracing her journey from the influence of a WWII veteran father who taught her the value of duty and compassion, to the mentors who guided her toward abdominal imaging, to the unexpected leadership opportunities that emerged during her military service at Andrews Air Force Base. Dr. Fulcher reflects on becoming a department chair earlier than she ever imagined, the lessons she carried from the Air Force into academic medicine, and the evolving challenges facing radiology's leaders today. She shares candid insights about building a cohesive culture across expanding clinical sites, sustaining research and education amid workforce pressures, and the responsibility leaders hold to champion quality and care in an increasingly productivity‑driven environment. Beyond radiology, Dr. Fulcher discusses the life‑changing role photography has played in her well‑being - awakening creativity, restoring balance, and even uplifting colleagues and patients during challenging times. Her reflections on mentorship, purpose, and “what you do with your dash” offer a moving reminder of the impact a single career can have. Engaging, humble, and full of heart, this conversation explores what it means to lead with clarity, compassion, and authenticity while never losing sight of the joy in the work itself. Production support for this episode of this RLI “Taking the Lead” podcast has been provided by the Virginia Radiological Society, a statewide professional organization dedicated to improving the health of patients and society by making imaging safe, effective and accessible to those who need it. Visit www.varadsoc.org for more information.

Adam Young is a trauma therapist and the host of The Place We Find Ourselves podcast. He is a Licensed Clinical Social Worker (LCSW) with master's degrees in social work (Virginia Commonwealth University) and divinity (Emory University). Adam regularly speaks at conferences and currently serves as a fellow with The Allender Center. He lives in Fort Collins, Colorado, with his wife and two children.

In September 2005, 17-year-old college freshman Taylor Behl left her dorm at Virginia Commonwealth University for a short late-night drive—and never returned. What began as a routine missing-person report quickly spiraled into a massive search effort that drew national attention and exposed a disturbing web of relationships, manipulation, and obsession.In this episode of Lurk, we retrace Taylor's final hours, the frantic investigation that followed, and the unexpected suspect who had been hiding in plain sight. From downtown Richmond to the quiet backroads of Mathews County, we follow the trail that ultimately led to the heartbreaking discovery of Taylor's body—and the truth behind her murder.Join us as we explore:Taylor Behl's life and first weeks at VCUHer sudden disappearance and the initial responseThe digital clues and MySpace connections that shaped the investigationThe eerie behavior of amateur photographer Benjamin FawleyHow search teams uncovered the location of Taylor's remainsThe case's resolution and the legal aftermathThis is the story of a promising young woman whose life was stolen—and of the dogged investigators, family members, and volunteers who refused to stop searching.Listener discretion is advised.Subscribe & Follow:Don't miss future episodes of Lurk! Follow us on Spotify Apple Podcasts etc. and hit that subscribe button.Join the conversation: Follow us on social media for updates, discussions, and to share your thoughts on this case.Lurk on FacebookLurk on TwitterLurk on InstagramWe have a new Facebook Group join in the discussion! Lurk Podcast Facebook GroupNew Merch Store!We are also now found on YouTube- Lurk on YouTubeBackground Music Royalty and Copyright Free MusicIntro and Outro music purchased through  AudioJunglewith Music Broadcast License (1 Million)Send us a textSupport the show

  Jonathan Bennet, owner of Unsprung Upholstery is originally from Martinsville, VA.  He caught the sewing bug from his great grandmother at a young age. He moved to Richmond, VA on a whim in August of 1989 and earned a BFA in Fashion Design from Virginia Commonwealth University. Directly after graduation, Jonathan taught in the Fashion Design department as an adjunct professor for 13 years. He started his first workroom job in 1997, learned how to make various types of window treatments, cushions, pillows, and more;  since then, he has done freelance workroom client projects in his home for over 25 years. Jonathan opened Unsprung Upholstery LLC in August 2019 and will continue this beautiful journey for the rest of his life!   Website:  UnsprungUpholstery.com IG:  UnsprungUpholstery FB:  Unsprung Upholstery Company Links and Resources; Real Workroom Tours Video with Jonathan, Jeanelle Dech and Kelly McCrory The Drapery & Design Digital Digest November/December 2025     The Sew Much More Podcast is sponsored by;     Klimaka Studios   The Workroom Channel   Scarlet Thread Consulting   The WCAA   The Curtains and Soft Furnishings Resource Library   National Upholstery Association   Workroom Tech    

Noah Scalin is an artist, author, and activist. He founded the art and innovation consultancy Another Limited Rebellion in 2001 with the idea that he could make a living doing what he enjoyed and effect positive change in the world. Since then, Noah has traveled the world bringing his message of creative practice to everyone from incarcerated teenagers to Fortune 500 executives. A graduate of NYU's Tisch School of The Arts, Noah started his career as the Art Director for Troma Entertainment and Avirex Clothing. Noah's artwork is collected internationally and has been exhibited in numerous museums and galleries, including the Virginia Museum of Fine Arts, the Mütter Museum and NYC's Times Square. He is the author of six books — most recently Creative Sprint which he co-wrote with his sister/business partner Mica. Noah was the inaugural artist-in-residence at both Virginia Commonwealth University's School of Business and the Strome College of Business at Old Dominion University. His 2020 collaboration with Old Navy was one of the most viewed commercials of the year and in 2022 he won the Artfields Grand Prize.Social media:https://www.linkedin.com/in/noahscalin/https://www.instagram.com/noahscalin/Websites:https://www.anotherlimitedrebellion.com/https://noahscalinkeynote.com/https://www.noahscalin.com/ ***********Susanne Mueller / www.susannemueller.biz TEDX Talk, May 2022: Running and Life: 5KM Formula for YOUR Successhttps://www.youtube.com/watch?v=oT_5Er1cLvY 700+ weekly blogs / 500+ podcasts / 1 Ironman Triathlon / 5 half ironman races / 26 marathon races / 4 books / 1 Mt. Kilimanjaro / 1 TEDx Talk

In this week's Monday News Drop, co-hosts Bo Brabo and Luke Carignan dive into one of healthcare's most persistent and pressing issues — the national nursing shortage. But this time, they go deeper than headlines to ask the hard question: Is it really a “trend,” or just a long-term problem we keep failing to solve?Bo and Luke trace the roots of the shortage through decades of reports and research, revealing that the so-called “hot topic” isn't new — it's been part of America's healthcare conversation for years. Together, they unpack why solutions haven't stuck and explore how operations, education, and compensation must all evolve to make a real difference.

Creating a learning and development strategy for supervision is essential for organizations that want to improve operational performance outcomes. In this third episode of a four-part series on learning and development strategic planning, host Joe White highlights key considerations and practical steps for successful plan implementation. View this episode on the AEU website.About JoeAs Director of AEU LEAD, Joe White focuses on helping members transform operational goals into actionable plans through a structured change management process. Prior to joining AEU, Joe was a senior consultant for E.I. DuPont's consulting division, DuPont Sustainable Solutions (DSS). He joined DSS in 2011 to develop the next generation of safety practices using extensive research in behavioral sciences he's compiled over a period of nearly two decades. His efforts resulted in the development of The Risk Factor, which is now the flagship instructor-led offering for the consulting division. Combined, Joe has 26 years of operational safety experience, the majority of which was with DuPont. Joe has been published in Occupational Health & Safety Magazine for his prominent work in safety relative to behavioral and neurosciences and is an event speaker at many leading industry conferences including National Safety Council (NSC) Congress and Expos, American Wind Energy Association (AWEA), and National Maritime Safety Association (NMSA). Joe is a graduate of Virginia Commonwealth University and has a B.S., in Safety and Risk Administration.Where you can find JoeConnect with Joe on LinkedInSupervisor Skills: Secrets of Success is a production of AEU LEAD, a division of The American Equity Underwriters, Inc. With 60 years of combined industry experience, our supervisor training program gives mid-level managers in the maritime industry the skills needed to influence employees, customers, and peers. This increases employee engagement, reduces turnover and rework, and ultimately results in higher profits for their companies. Find AEU: amequity.com | Linkedin | Facebook

Nothing ruins a nature walk like a tick bite, and scientists say concerns from those bites are growing beyond Lyme disease. Brad Kutner has this report on a new study out of Virginia Commonwealth University. 

Summary This podcast episode from the Boss Surgery Series features Dr. Amy Vertries interviewing Dr. Sarah Rasmussen, a pediatric transplant surgeon, about her experience of being in the wrong job and navigating a career transition. Dr. Rasmussen shares her journey from working at the University of Virginia (UVA) to Seattle Children's Hospital and then to a new position that better aligned with her career goals and values. Dr. Rasmussen begins by describing her background as a Gen-Xer born in West Virginia who initially planned to practice medicine with her father. She pursued an MD-PhD program at WVU in 1997, focusing on HIV research at the National Cancer Institute. During her medical training, she discovered her passion for surgery during rotations and completed her residency at Virginia Commonwealth University followed by a pediatric surgery fellowship at Johns Hopkins. She then worked at UVA from 2011 to 2020, where she established a pediatric liver transplant program in partnership with Children's Hospital of Pittsburgh. Dr. Rasmussen explains that leadership changes at UVA led to her role being reduced from performing 42 liver transplants annually to being limited to only pediatric cases (about 5 per year). This significant reduction in surgical volume prompted her to accept a position at Seattle Children's Hospital as the surgical director of pediatric liver transplant, which she accepted just before the COVID-19 pandemic began in early 2020. At Seattle Children's, Dr. Rasmussen encountered challenges that made her realize she was in the wrong job. Despite the hospital performing more transplants (13-15 liver transplants and 30 kidney transplants annually), she faced issues with case allocation, micromanagement of her decisions, and resistance to her suggestions for improving processes. After 18 months, she compiled data showing her limited involvement in transplant cases and presented it to leadership, hoping for change. Instead, this led to increased scrutiny of her abilities. Dr. Rasmussen describes how the job stress affected her health, causing panic attacks, chest pain, and dangerously high blood pressure. With support from her family and through Dr. Vertries' coaching program, she decided to explore other opportunities. She interviewed at four institutions and found a position with a partner who shared her vision and valued her contributions. In her new role, Dr. Rasmussen found a supportive environment where her partner encourages her growth, helps her through complications, and values her strengths. She shares how her new partner supported her through a surgical complication by not letting her isolate herself and helping her move past self-doubt. He also encourages her to take on challenging cases, such as performing laparoscopic procedures on very small infants. The conversation concludes with reflections on the importance of finding the right job fit, the impact of career decisions on family, and how having the right partner can make a significant difference in professional growth and satisfaction. Chapters Dr. Rasmussen's Background and Early Career Path ‎ 00:02:12 Dr. Sarah Rasmussen introduces herself as a Gen-Xer born in West Virginia. She initially planned to practice medicine with her father but became interested in research during medical school. She joined an MD-PhD program at WVU in 1997, focusing on HIV research at the National Cancer Institute. During her clinical rotations, she discovered her passion for surgery, which engaged "all parts of her brain." She completed her residency at Virginia Commonwealth University and a pediatric surgery fellowship at Johns Hopkins. From 2011 to 2020, she worked at the University of Virginia (UVA) as an assistant professor, where she also completed an additional fellowship in abdominal transplant surgery. At UVA, she was active in research, clinical work, teaching, and helped establish a pediatric liver transplant program in partnership with Children's Hospital of Pittsburgh. Transition to Seattle Children's Hospital During the Pandemic ‎ 00:05:21 Dr. Rasmussen explains that leadership changes at UVA led to her role being reduced from performing 42 liver transplants annually to being limited to only pediatric cases (about 5 per year). This significant reduction prompted her to accept a position as surgical director of pediatric liver transplant at Seattle Children's Hospital. She signed her offer letter just before the COVID-19 pandemic began, making the transition particularly challenging as it occurred during social distancing measures. Dr. Rasmussen was attracted to Seattle Children's because they performed more transplants (13-15 liver transplants and 30 kidney transplants annually), and she believed she would have a good working relationship with the program head who had similar training. Challenges at Seattle Children's Hospital ‎ 00:09:27 Dr. Rasmussen describes her initial positive reception at Seattle Children's but quickly noticed concerning dynamics between surgeons during her observation of a liver-kidney transplant on her second day. Despite her efforts to integrate into the team, she faced significant challenges: her clinical decisions were micromanaged, her requests for time off were complicated by "unwritten rules," and she was often excluded from transplant cases because "fellows needed the experience." After 12 months, she realized that her situation wasn't improving despite her efforts to be helpful and engaged. After 18 months, she compiled data showing her limited involvement in transplant cases (only 20% of livers and 15% of kidneys despite being on call 33% of the time) and presented it to leadership, hoping for change. Instead of addressing her concerns, this led to increased scrutiny of her abilities. Recognizing the Need for Change ‎ 00:16:45 Dr. Rasmussen sought advice from colleagues but was consistently told that the situation "would never change." She realized that her vision of being a pediatric liver transplant surgeon required meaningful involvement in cases, which wasn't happening at Seattle. In January 2021, she learned of four potential job openings in her field. Initially resistant to moving her family again so soon after relocating during the pandemic, she joined Dr. Vertries' "difficult partner course" hoping to learn how to succeed in her current position. Through the course, she gave herself permission to explore other opportunities and interviewed at all four institutions. Two positions seemed promising, with one standing out immediately because of her connection with the potential new boss. Health Impact and Decision to Leave ‎ 00:25:56 Dr. Rasmussen describes how the job stress severely affected her health, causing panic attacks manifesting as chest pain and dangerously high blood pressure (190/110 with a heart rate of 197). One night after seeing the clinic and call schedule, she couldn't calm down despite trying mindfulness techniques. Her husband witnessed this and declared, "We are done here." Additional factors influencing her decision included the death of a mentor and her mother's illness. Dr. Rasmussen realized that despite her efforts, the team at Seattle Children's was unwilling to accommodate her career needs, which she viewed as a "breach of contract" - not from the institution but from the team that should invest in its members. Family Considerations in Career Decisions ‎ 00:28:55 Dr. Rasmussen discusses the challenge of considering another move so soon after relocating her family during the pandemic. She worried about uprooting her children who had just established connections in Seattle. A turning point came when her oldest child told her, "Mom, I think it's time for you to worry about yourself. I'm going to be okay." For her job interviews, she took the unusual step of requesting that both potential employers bring her entire family for second visits, not just her spouse. She received advice that "how happy do you think your family can be if mom is not happy?" and realized that many children move multiple times during childhood without negative consequences. She also learned that her oldest child had been bullied at their previous school, reinforcing that staying in Virginia might not have been better for her family. Finding the Right Partner and Environment ‎ 00:47:08 Dr. Rasmussen describes how she connected with her new boss by cold-calling him about a position at his former institution and inquiring if he needed a partner in his new program. Their initial conversation revealed shared vision and energy for building a program. Unlike her experience in Seattle, her new boss explicitly stated, "You tell me what you need out of a case, and that's what will happen," emphasizing team function over hierarchy. She contrasts this with her previous experience, noting the difference between a hierarchical environment and one with a shared vision. When she experienced a serious complication in her first liver transplant at the new institution, her partner provided support without judgment, wouldn't let her isolate herself, and eventually told her "it's time to stop" ruminating, while acknowledging that such complications happen to everyone. Growth and Support in the New Position ‎ 00:54:01 Dr. Rasmussen shares how her new environment supports her growth through challenging cases. During her first on-call experience, she consulted on a 1.6-kilogram baby with duodenal atresia. Though initially planning an open procedure, she researched laparoscopic approaches and found evidence supporting minimally invasive surgery for this condition. When she proposed this to her boss, he gave no pushback and even came to observe the successful procedure. Three months later, when she hesitated about performing a laparoscopic cholecystectomy on an eight-week-old baby, her boss reminded her, "Three months ago, you did a lap duodenal atresia repair on a 1.6 kilo baby - get over it," encouraging her to trust her abilities. Dr. Rasmussen appreciates how her partner recognizes when her tendency to overthink is a strength (when writing policies or justifications) and when it's holding her back. Reflections on Career Transitions and Lessons Learned ‎ 01:00:00 Dr. Rasmussen and Dr. Vertries reflect on the lessons learned through this career journey. Dr. Rasmussen acknowledges how she overcame limiting beliefs such as "I can't move because it will hurt my family" and "I can't have an ideal partner." Dr. Vertries notes that Dr. Rasmussen has experienced a "hero's journey" and that her lessons will have an "exponential effect on other people." Dr. Rasmussen expresses gratitude for the opportunity to reflect on how far she's come in a relatively short time, demonstrating that "you can make some pretty life-altering things in a short period of time with a little bit of help." Action Items Dr. Vertries mentioned reaching out to her at bosssurgery.com for help with toxic job situations. ‎ 00:00:35 Dr. Rasmussen suggested asking detailed questions about job expectations and case allocation when interviewing for new positions. ‎ 00:13:54 Dr. Rasmussen recommended bringing family members on second job interviews when considering relocation. ‎ 00:29:58 Dr. Rasmussen advised seeking coaching before leaving a job to process the situation properly. ‎ 00:42:17 Dr. Rasmussen suggested researching evidence-based approaches to surgical techniques when considering new procedures. ‎ 00:55:57

Limb-girdle muscular dystrophies (LGMDs) encompass a group of genetically heterogeneous skeletal muscle disorders. There has been an explosion of newly identified LGMD subtypes in the past decade, and results from preclinical studies and early-stage clinical trials of genetic therapies are promising for future disease-specific treatments. In this episode, Gordon Smith, MD, FAAN, speaks with Teerin Liewluck, MD, FAAN, FANA, author of the article “Limb-Girdle Muscular Dystrophies” in the Continuum® October 2025 Muscle and Neuromuscular Junction Disorders issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Liewluck is a professor of neurology at the Division of Neuromuscular Medicine and Muscle Pathology Laboratory at Mayo Clinic College of Medicine in Rochester, Minnesota. Additional Resources Read the article: Limb-Girdle Muscular Dystrophies Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @TLiewluck Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: This is Dr Gordon Smith with Continuum Audio. Today I'm interviewing Dr Teerin Liewluck, a good friend of mine at the Mayo Clinic, about his article on the limb girdle muscular dystrophies. This article appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders, a topic that is near and dear to my heart. Teerin, welcome to the podcast, and maybe you can introduce yourself to our listeners. Dr Liewluck: Thank you very much, Gordon, and I want to say hi to all the Continuum fans. So, I'm Dr Teerin Liewluck, I'm the professor of neurology at Mayo Clinic in Rochester, Minnesota. So, my practice focus on all aspects of muscle diseases, both acquired and genetic myopathies. Glad to be here. Dr Smith: I just had the great pleasure of seeing you at a seminar in Houston where you talked about this topic. And so, I'm really primed for this conversation, which I'm very excited about. I find this topic a little hard, and I'm hoping I can learn more from you. And I wonder if, as we get started, recognizing many of our listeners are not in practices focused purely on muscle disease, maybe you can provide some context about why this is important for folks doing general neurology or even general neuromuscular medicine? Why do they need to know about this? Dr Liewluck: Yes, certainly. So, I would say limb girdle muscular dystrophy probably the most complex category of subgroup of muscle diseases because, by itself, it includes thirty-four different subtypes, and the number's still expanding. So, each subtype is very rare. But if you group together, it really have significant number of patients, and these patients present with proximal weakness, very high CK, and these are common patients that can show up in the neurology clinic. So, I think it's very important even for general neurologists to pick up what subtle clues that may lead to the diagnosis because if we are able to provide correct diagnosis for the patients, that's very important for patient management. Dr Smith: So, I wonder if maybe we can talk a little bit about the phenotype, Terran. I mean, your article does a great job of going over the great diversity. And you know, I think many of us here, you know, limb girdle muscular dystrophy and we think of limb girdle weakness, but the phenotypic spectrum is bananas, right? Rhabdomyolysis, limb girdle distal myopathy. I mean, when should our listeners suspect LGMD? Dr Liewluck: Yes, I think by the definition to all the LGMD patients will have limb girdle of proximal weakness and very high CK. So, these are common phenotypes among thirty-four different subtypes. But if it did take into details, they have some subtle differences. In the article, what I try to simplify all these different subtypes that we can categorize at least half of them into three main group that each group the underlying defect sharing among those subtypes and also translate into similar muscles and extra muscular manifestations. You will learn that some of the limb girdle muscular dystrophy may present with rhabdomyolysis. And we typically think of this as metabolic myopathies. But if you have a rhabdomyolysis patient, the CK remain elevated even after the acute episode, that's the key that we need to think this could be LGMD. That's for an example. Dr Smith: So, I wonder if maybe we can start there. I was going to go in a different direction, but this is a good transition. It's easy to see the opportunity to get confused between LGMD or, in that case, a metabolic myopathy or other acquired myopathies. And I think particularly adult neurologists are more accustomed to seeing acquired muscle disease. Are there particular clues that, or pearls that adult neurologists seeing patients with muscle disease can use to recognize when they should be thinking about LGMD given the diverse phenotype? Dr Liewluck: Yes. What I always tell the patient is that there are more than a hundred different types of muscle diseases, but we can easily divide into groups: acquired and genetic or hereditary. So, the acquired disease is when you encounter the patients who present with acute or subacute cause of the weakness, relatively rapidly progressive. But on the opposite, if you encounter the patient who present with a much more slowly progressive cause of weakness over several months or years, you may need to think about genetic disease of the muscle with also including limb-girdle muscular dystrophy. The detailed exam to be able to distinguish between each type of muscular dystrophy. For example, if proximal weakness, certainly limb girdle muscular dystrophy. If a patient has facial weakness, scapular winking, so you would think about facial scapular hematoma dystrophy. So, the slowly progressive cause of weakness, proximal pattern of weakness, CK elevation, should be the point when you think about LGMD. Dr Smith: So, I have a question about diagnostic evaluation. I had a meeting with one of my colleagues, Qihua Fan, who's a great peripheral nerve expert, who also does neuromuscular pathology. And we were talking about how the pathology field has changed so much over the last ten years, and we're doing obviously fewer muscle biopsies. Our way of diagnosing them has changed a lot with the evolution of genetic testing. What's your diagnostic approach? Do you go right to genetic testing? Do you do targeted testing based on phenotype? What words of wisdom do you have there? Dr Liewluck: Yes, so, I mean, being a muscle pathologist myself, it is fair to say that the utility of muscle biopsies when you encounter a patient with suspects that limb girdle muscular dystrophy have reduced over the year. For example, we used to have like fifteen, seventeen hundred muscle biopsies a year; now we do only thirteen hundred biopsies a year. Yes, as you pointed out, the first step in my practice if I suspect LGMD is to go with genetic testing. And I would prefer the last gene panel that not only include the LGMD, but also include all other genetic muscle disease as well as the conjunctive myopic syndrome, because the phenotype can be somehow difficult to distinguish in certain patients. Dr Smith: So, do you ever get a muscle biopsy, Teerin? I mean you obviously do; only thirteen hundred. Holy cow, that's a lot. So, let me reframe my question. When do you get a muscle biopsy in these patients? Dr Liewluck: Muscle biopsy still is present in LGMD patients, it's just we don't use it at the first-tier diagnostic test anymore. So, we typically do it in selected cases after the genetic testing in those that came back inconclusive. As you know, you may run into the variant of unknown significance. You may use the muscle biopsy to see, is there any histopathology or abnormal protein Western blot that may further support the heterogenicity of the VUS. So, we still do it, but it typically comes after genetic testing and only in the selected cases that have inconclusive results or negative genetic testing. Dr Smith: I'd like to ask a question regarding serologic testing for autoantibodies. I refer to a really great case in your article. There are several of them, but this is a patient, a FKRP patient, who was originally thought to have dermatomyositis based on a low-titer ME2 antibody. You guys figured out the correct diagnosis. We send a lot of antibody panels out. Wonder if you have any wisdom, pearls, pitfalls, for how to interpret antibody tests in patients with chronic myopathies? We send a lot of them. And that's the sort of population where we need to be thinking about limb-girdle muscular dystrophies. It's a great case for those, which I hope is everyone who read your article in detail. What do you have to say about that? Dr Liewluck: Yes, so myositis antibodies, we already revolutionized a few of muscle diseases. I recall when I finished my fellowship thirteen years ago, so we don't really have much muscle myositis antibodies to check. But now the panel is expanded. But again, the antibodies alone cannot lead to diagnosis. You need to go back to your clinical. You need to make sure the clinical antibodies findings are matched. For example, if the key that- if the myocytes specific antibodies present only at the low positive title, it's more often to be false positive. So, you need to look carefully back in the patient, the group of phenotypes, and when in doubt we need to do muscle biopsies. Now on the opposite end, the other group of the antibody is the one for necrotizing autoimmune myopathy; or, the other name, immune-mediated necrotizing myopathy. This is the new group that we have learned only just recently that some patients may present as a typical presentation. I mean, when even thinking about the whole testing autoimmune myopathy, we think about those that present with some acute rapidly progressive weakness, maybe has history of sudden exposures. But we have some patients that present with very slowly progressive weakness like muscular dystrophies. So now in my practice, if I encounter a patient I suspect LGMD, in addition to doing genetic testing for LGMD, I also test for necrotizing doing with myopathy antibodies at the same time. And we typically get antibody back within what, a week or two, but projected testing would take a few months. Dr Smith: Yeah. And I guess maybe you could talk a little bit about pitfalls and interpretation of genetic tests, right? I think you have another case in your article, and I've certainly seen this, where a patient is misdiagnosed as having a genetic myopathy, LGMD, based on, let's say, just a misinterpretation of the genetic testing, right? So, I think we need to think of it on both sides. And I like the fact that the clinical aspects of diagnosis really are first and foremost most important. But maybe you can talk about wisdom in terms of interpretation of the genetic panel?  Dr Liewluck:Yes. So genetic testing, I think, is a complex issue, particularly for interpretation. And if you're not familiar with this, it's probably best to have your colleagues in genetics that help looking at this together. So, I think the common scenario we encounter is that in those dystrophies that are autosomal recessive, so we expect that the patient needs to have two abnormal copies of the genes to cause the disease. And if patients have only one abnormal copy, they are just a carrier. And commonly we see patients refer to us as much as dystrophy is by having only one abnormal copy. If they are a carrier, they should not have the weakness from that gene abnormality. So, this would be the principle that we really need to adhere. And if you run into those cases, then maybe you need to broaden your differential diagnosis. Dr Smith: I want to go back to the clinical phenomenology, and I've got a admission to make to you, Teerin. And I find it really hard to keep track of these disorders at, you know, thirty-four and climbing a lot of overlap, and it's hard to remember them. And I'm glad that I'm now going to have a Continuum article I can go to and look at the really great tables to sort things out. I'm curious whether you have all these top of mind? Do you have to look at the table too? And how should people who are seeing these patients organize their thoughts about it? I mean, is it important that you memorize all thirty-four plus disorders? How can you group them? What's your overall approach to that? Dr Liewluck: I need to admit that I've not memorize all twenty-four different subtypes, but I think what I triy to do even in my real-life practice is group it all together if you can. For example, I think that the biggest group of these LGMD is what we call alpha-dystroglycanopathies. So, this include already ten different subtypes of recessive LGMD. So alpha-dystroglycan is the core of the dystrophin-associated glycoprotein complex. And it's heavy glycosylated protein. So, the effect in ten different genes can affect the glycosylation or the process of adding sugar chain to this alpha-dystroglycan. And they have similar features in terms of the phenotype. They present with proximal weakness, calf pseudohypertrophy, very high CK, some may have recurrent rhabdomyolysis, and cardiac and rhythmic involvement are very common. This is one major group. Now the second group is the limb-girdle muscular dystrophy due to defective membrane repair, which includes two subtypes is the different and on dopamine five. The common feature in this group is that the weakness can be asymmetric and despite proximal weakness, they can have calf atrophy. On muscle biopsy sometimes you can see a myeloid on the muscle tissues. And the third group is the sarcoglycanopathy, which includes four different subtypes, and the presentation can look like we share. For the rest, sometimes go back to the table. Dr Smith: Thank you for that. And it prompts another question that I always wonder about. Do you have any theories about why such variability in the muscle groups that are involved? I mean, you just brought up dystroglycanopathy, for instance, as something that can cause a very distal predominant myopathy; others do not. Do we at this point now have an understanding given the better genetics that we have on this and work going on in therapeutic development, which I want to get to in a minute, that provides any insight why certain muscle groups are more affected? Dr Liewluck: Very good question, Gordon. And I would say the first question that led me interested in muscle disease---and this happened probably back in 2000 when I just finished medical school---is why, why, why? Why does muscle disease tend to affect proximal muscles? I thought by now, twenty-five years later, we'd have the answer. I don't. I think this, you don't know clearly why muscle diseases, some affect proximal, some affect distal. But the hypothesis is, and probably my personal hypothesis is, that maybe certain proteins may express more in certain muscles and that may affect different phenotypes. But, I mean, dysferlin has very good examples that can confuse us because some patients present with distal weakness, some patients present with proximal weakness, that's by the same gene defect. And in this patient, when we look at the MRI in detail, actually the patterns of fatty replacements in muscle are the same. Even patient who present clinically as a proximal or distal weakness, the imaging studies show the same finding. Bottom line, we don't know. Dr Smith: Yeah, who knew it could be so complex? Teerin, you brought up a really great point that I wanted to ask about, which is muscle MRI scan, right? We're now seeing studies that are doing very broad MR imaging. Do you use some muscle MRI very frequently in your clinical evaluation of these patients? And if so, how? Dr Liewluck: Maybe I don't use it as much as I could, but the most common scenario I use in this setting is when I have the genetic testing come back with the VUS. So, we look at each VUS, each gene in detail. And if anything is suspicious, what I do typically go back to the literature to see if that gene defect in particular has any common pattern of muscle involvement on the MRI. And if there is, I use MRI as one of the two to try to see if I can escalate the pathogenicity of that VUS. Dr Smith: And a VUS is a “Variant of Unknown Significance,” for our listeners. I'm proud that I remember that as a geneticist. These are exciting times in neurology in general, but particularly in an inherited muscle disease. And we're seeing a lot of therapeutic development, a lot going on in Duchenne now. What's the latest in terms of disease-modifying therapeutics and gene therapies in LGMD? Dr Liewluck: Yes. So, there are several precritical and early-phase critical trials for gene therapy for the common lymphoma of muscular dystrophies. For example, the sarcoglycanopathies, and they also have some biochemical therapy that arepossible for the LGMD to FKRP. But there are many things that I expect probably will come into the picture broader or later phase of critical tryouts, and hopefully we have something to offer for the patients similar to patients with Duchenne muscular dystrophy. Dr Smith: What haven't we talked about, I mean, holy cow? There's so much in your article. What's one thing we haven't talked about that our listeners need to hear? Dr Liewluck: Good questions. So, I think we covered all, but often we get patients with proximal weakness and high CK, and they all got labeled as having limb-girdlemuscular dystrophy. What I want to stress is that proximal weakness and high CK is a common feature for muscle diseases, so they need to think broad, need to think about all possibilities. Particularly don't want to miss something treatable. Chronic, slowly progressive cause, as I mentioned earlier, we think more about muscle dystrophy, but at the cranial range, we know that rare patients with necrotic autonomyopathy and present with limb good of weakness at a slowly progressive cost. So, make sure you think about these two when suspecting that LGMD patient diabetic testing has come back inconclusive. Dr Smith: Well, that's very helpful. And fortunately, there's several other articles in this issue of Continuum that help people think through this issue more broadly. Teerin, you certainly don't disappoint. I enjoyed listening to you about a month ago, and I enjoyed reading your article a great deal and enjoy talking to you even more. Thank you very much. Dr Liewluck: Thank you very much, Gordon. Dr Smith: Again, today I've been interviewing Dr Teerin Liewluck about his article on limb-girdle muscular dystrophy, which appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders. Please be sure to check out Continuum Audio episodes for this and other issues. And thanks to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

The announcement by Erika Kirk – the widow of assassinated political activist Charlie Kirk – that she forgave her husband's killer, has led many to question the nature of Christian forgiveness. Granting forgiveness can seem hard for the smallest of crimes, let alone the murder of a close family member, so how can other people follow Erika's example? One person who sadly knows better than most is Professor Everett Worthington. Prof. Worthington is Professor Emeritus at Virginia Commonwealth University and a clinical psychologist who has studied forgiveness throughout his career. However, it isn't just through academia that he understands forgiveness; when his mother was murdered, he also made the decision to forgive his mother's killer.Prof. Worthington joins Damian Thompson on this episode of Holy Smoke to discuss the 'injustice gap' between forgiveness and remorse, the theoretical distinction he makes between behaviourial intentions and emotional forgiveness, and the events of his mother's murder – and how he came to forgive such an horrific crime.Produced by Patrick Gibbons. Hosted on Acast. See acast.com/privacy for more information.

The announcement by Erika Kirk – the widow of assassinated political activist Charlie Kirk – that she forgave her husband's killer, has led many to question the nature of Christian forgiveness. Granting forgiveness can seem hard for the smallest of crimes, let alone the murder of a close family member, so how can other people follow Erika's example? One person who sadly knows better than most is Professor Everett Worthington. Prof. Worthington is Professor Emeritus at Virginia Commonwealth University and a clinical psychologist who has studied forgiveness throughout his career. However, it isn't just through academia that he understands forgiveness; when his mother was murdered, he also made the decision to forgive his mother's killer. Prof. Worthington joins Damian Thompson on this episode of Holy Smoke to discuss the 'injustice gap' between forgiveness and remorse, the theoretical distinction he makes between behaviourial intentions and emotional forgiveness, and the events of his mother's murder – and how he came to forgive such an horrific crime.Produced by Patrick Gibbons.Become a Spectator subscriber today to access this podcast without adverts. Go to spectator.co.uk/adfree to find out more.For more Spectator podcasts, go to spectator.co.uk/podcasts. Contact us: podcast@spectator.co.uk Hosted on Acast. See acast.com/privacy for more information.

Functional movement disorders are a common clinical concern for neurologists. The principle of “rule-in” diagnosis, which involves demonstrating the difference between voluntary and automatic movement, can be carried through to explanation, triage, and evidence-based multidisciplinary rehabilitation therapy. In this episode, Gordon Smith, MD, FAAN speaks Jon Stone, PhD, MB, ChB, FRCP, an author of the article “Multidisciplinary Treatment for Functional Movement Disorder” in the Continuum® August 2025 Movement Disorders issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Stone is a consultant neurologist and honorary professor of neurology at the Centre for Clinical Brain Sciences at the University of Edinburgh in Edinburgh, United Kingdom. Additional Resources Read the article: Multidisciplinary Treatment for Functional Movement Disorder Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @jonstoneneuro Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. This exclusive Continuum Audio interview is available only to you, our subscribers. We hope you enjoy it. Thank you for listening. Dr Smith: Hello, this is Dr Gordon Smith. Today I've got the great pleasure of interviewing Dr Johnstone about his article on the multidisciplinary treatment for functional neurologic disorder, which he wrote with Dr Alan Carson. This article will appear in the August 2025 Continuum issue on movement disorders. I will say, Jon, that as a Continuum Audio interviewer, I usually take the interviews that come my way, and I'm happy about it. I learn something every time. They're all a lot of fun. But there have been two instances where I go out and actively seek to interview someone, and you are one of them. So, I'm super excited that they allowed me to talk with you today. For those of our listeners who understand or are familiar with FND, Dr Stone is a true luminary and a leader in this, both in clinical care and research. He's also a true humanist. And I have a bit of a bias here, but he was the first awardee of the Ted Burns Humanism in Neurology award, which is a real honor and reflective of your great work. So welcome to the podcast, Jon. Maybe you can introduce yourself to our audience. Dr Stone: Well, thank you so much, Gordon. It was such a pleasure to get that award, the Ted Burns Award, because Ted was such a great character. I think the spirit of his podcasts is seen in the spirit of these podcasts as well. So, I'm a neurologist in Edinburgh in Scotland. I'm from England originally. I'm very much a general neurologist still. I still work full-time. I do general neurology, acute neurology, and I do two FND clinics a week. I have a research group with Alan Carson, who you mentioned; a very clinical research group, and we've been doing that for about 25 years. Dr Smith: I really want to hear more about your clinical approach and how you run the clinic, but I wonder if it would be helpful for you to maybe provide a definition. What's the definition of a functional movement disorder? I mean, I think all of us see these patients, but it's actually nice to have a definition. Dr Stone: You know, that's one of the hardest things to do in any paper on FND. And I'm involved with the FND society, and we're trying to get together a definition. It's very hard to get an overarching definition. But from a movement disorder point of view, I think you're looking at a disorder where there is an impairment of voluntary movement, where you can demonstrate that there is an automatic movement, which is normal in the same movement. I mean, that's a very clumsy way of saying it. Ultimately, it's a disorder that's defined by the clinical features it has; a bit like saying, what is migraine? You know? Or, what is MS? You know, it's very hard to actually say that in a sentence. I think these are disorders of brain function at a very broad level, and particularly with FND disorders, of a sort of higher control of voluntary movement, I would say. Dr Smith: There's so many pearls in this article and others that you've written. One that I really like is that this isn't a diagnosis of exclusion, that this is an affirmative diagnosis that have clear diagnostic signs. And I wonder if you can talk a little bit about the diagnostic process, arriving at an FND diagnosis for a patient. Dr Stone: I think this is probably the most important sort of “switch-around” in the last fifteen, twenty years since I've been involved. It's not new information. You know, all of these diagnostic signs were well known in the 19th century; and in fact, many of them were described then as well. But they were kind of lost knowledge, so that by the time we got to the late nineties, this area---which was called conversion disorder then---it was written down. This is a diagnosis of exclusion that you make when you've ruled everything out. But in fact, we have lots of rule in signs, which I hope most listeners are familiar with. So, if you've got someone with a functional tremor, you would do a tremor entrainment test where you do rhythmic movements of your thumb and forefinger, ask the patient to copy them. It's very important that they copy you rather than make their own movements. And see if their tremor stops briefly, or perhaps entrains to the same rhythm that you're making, or perhaps they just can't make the movement. That might be one example. There's many examples for limb weakness and dystonia. There's a whole lot of stuff to learn there, basically, clinical skills. Dr Smith: You make a really interesting point early on in your article about the importance of the neurological assessment as part of the treatment of the patient. I wonder if you could talk to our listeners about that. Dr Stone: So, I think, you know, there's a perception that- certainly, there was a perception that that the neurologist is there to make a diagnosis. When I was training, the neurologist was there to tell the patient that they didn't have the kind of neurological problem and to go somewhere else. But in fact, that treatment process, when it goes well, I think begins from the moment you greet the patient in the waiting room, shake their hand, look at them. Things like asking the patient about all their symptoms, being the first doctor who's ever been interested in their, you know, horrendous exhaustion or their dizziness. You know, questions that many patients are aware that doctors often aren't very interested in. These are therapeutic opportunities, you know, as well as just taking the history that enable the patient to feel relaxed. They start thinking, oh, this person's actually interested in me. They're more likely to listen to what you've got to say if they get that feeling off you. So, I'd spend a lot of time going through physical symptoms. I go through time asking the patient what they do, and the patients will often tell you what they don't do. They say, I used to do this, I used to go running. Okay, you need to know that, but what do they actually do? Because that's such valuable information for their treatment plan. You know, they list a whole lot of TV shows that they really enjoy, they're probably not depressed. So that's kind of useful information. I also spend a lot of time talking to them about what they think is wrong. Be careful, that they can annoy patients, you know. Well, I've come to you because you're going to tell me what's wrong. But what sort of ideas had you had about what was wrong? I need to know so that I can deal with those ideas that you've had. Is there a particular reason that you're in my clinic today? Were you sent here? Was it your idea? Are there particular treatments that you think would really help you? These all set the scene for what's going to come later in terms of your explanation. And, more importantly, your triaging of the patient. Is this somebody where it's the right time to be embarking on treatment, which is a question we don't always ask yourself, I think. Dr Smith: That's a really great point and kind of segues to my next question, which is- you talked a little bit about this, right? Generally speaking, we have come up with this is a likely diagnosis earlier, midway through the encounter. And you talked a little bit about how to frame the encounter, knowing what's coming up. And then what's coming up is sharing with the patient our opinion. In your article, you point out this should be no different than telling someone they have Parkinson's disease, for instance. What pearls do you have and what pitfalls do you have in how to give the diagnosis? And, you know, a lot of us really weren't trained to do this. What's the right way, and what are the most common land mines that folks step on when they're trying to share this information with patients? Dr Stone: I've been thinking about this for a long time, and I've come to the conclusion that all we need to do with this disorder is stop being weird. What goes wrong? The main pitfall is that people think, oh God, this is FND, this is something a bit weird. It's in a different box to all of the other things and I have to do something weird. And people end up blurting out things like, well, your scan was normal or, you haven't got epilepsy or, you haven't got Parkinson's disease. That's not what you normally do. It's weird. What you normally do is you take a deep breath and you say, I'm sorry to tell you've got Parkinson's disease or, you have this type of dystonia. That's what you normally say. If you follow the normal- what goes wrong is that people don't follow the normal rules. The patient picks up on this. What's going on here? This doctor's telling me what I don't have and then they're starting to talk about some reason why I've got this, like stress, even though I don't- haven't been told what it is yet. You do the normal rules, give it a name, a name that you're comfortable with, preferably as specific as possible: functional tremor, functional dystonia. And then do what you normally do, which is explain to the patient why you think it's this. So, if someone's got Parkinson's, you say, I think you've got Parkinson's because I noticed that you're walking very slowly and you've got a tremor. And these are typical features of Parkinson. And so, you're talking about the features. This is where I think it's the most useful thing that you can do. And the thing that I do when it goes really well and it's gone badly somewhere else, the thing I probably do best, what was most useful, is showing the patient their signs. I don't know if you do that, Gordon, but it's maybe not something that we're used to doing. Dr Smith: Wait, maybe you can talk more about that, and maybe, perhaps, give an example? Talk about how that impacts treatment. I was really impressed about the approach to physical therapy, and treatment of patients really leverages the physical examination findings that we're all well-trained to look for. So maybe explore that a little bit. Dr Stone: Yeah, I think absolutely it does. And I think we've been evolving these thoughts over the last ten or fifteen years. But I started, you know, maybe about twenty years ago, started to show people their tremor entrainment tests. Or their Hoover sign, for example; if you don't know Hoover sign, weakness of hip extension, that comes back to normal when the person's flexing their normal leg, their normal hip. These are sort of diagnostic tricks that we had. Ahen I started writing articles about FND, various senior neurologists said to me, are you sure you should write this stuff down? Patients will find out. I wrote an article with Marc Edwards called “Trick or Treat in Neurology” about fifteen years ago to say that actually, although they're they might seem like tricks, there really are treats for patients because you're bringing the diagnosis into the clinic room. It's not about the normal scan. You can have FND and MS. It's not about the normal scan. It's about what you're seeing in front of you. If you show that patient, yes, you can't move your leg. The more you try, the worse it gets. I can see that. But look, lift up your other leg. Let me show you. Can you see now how strong your leg is? It's such a powerful way of communicating to the patient what's wrong with them diagnostically, giving them that confidence. What it's also doing is showing them the potential for improvement. It's giving them some hope, which they badly need. And, as we'll perhaps talk about, the physio treatment uses that as well because we have to use a different kind of physio for many forms of functional movement disorder, which relies on just glimpsing these little moments of normal function and promoting them, promoting the automatic movement, squashing down that abnormal pattern of voluntary movement that people have got with FND. Dr Smith: So, maybe we can talk about that now. You know, I've got a bunch of other questions to ask you about mechanism and stuff, but let's talk about the approach to physical therapy because it's such a good lead-in and I always worry that our physical therapists aren't knowledgeable about this. So, maybe some examples, you have some really great ones in the article. And then words of wisdom for us as we're engaging physical therapists who may not be familiar with FND, how to kind of build that competency and relationship with the therapist with whom you work. Dr Stone: Some of the stuff is the same. Some of the rehabilitation ideas are similar, thinking about boom and bust activity, which is very common in these patients, or grading activity. That's similar, but some of them are really different. So, if you have a patient with a stroke, the physiotherapist might be very used to getting that person to think and look at their leg to try and help them move, which is part of their rehabilitation. In FND, that makes things worse. That's what's happening in Hoover sign and tremor entrainment sign. Attention towards the limb is making it worse. But if the patient's on board with the diagnosis and understands it, they'll also see what you need to do, then, in the physio is actively use distraction in a very transparent way and say to the patient, look, I think if I get you to do that movement, and I'll film you, I think your movement's going to look better. Wouldn't that be great if we could demonstrate that? And the patient says, yeah, that would be great. We're kind of actively using distraction. We're doing things that would seem a bit strange for someone with other forms of movement disorder. So, the patients, for example, with functional gait disorders who you discover can jog quite well on a treadmill. In fact, that's another diagnostic test. Or they can walk backwards, or they can dance or pretend that they're ice skating, and they have much more fluid movements because their ice skating program in their brain is not corrupted, but their normal walking program is. So, can you then turn ice skating or jogging into normal walking? It's not that complicated, I think. The basic ideas are pretty simple, but it does require some creativity from whoever's doing the therapy because you have to use what the patient's into. So, if the patient used to be a dancer- we had a patient who was a, she was really into ballet dancing. Her ballet was great, but her walking was terrible. So, they used ballet to help her walk again. And that's incredibly satisfying for the therapist as well. So, if you have a therapist who's not sure, there are consensus recommendations. There are videos. One really good success often makes a therapist want to do that again and think, oh, that's interesting. I really helped that patient get better. Dr Smith: For a long time, this has been framed as a mental health issue, conversion disorder, and maybe we can talk a little bit about early life of trauma as a risk factor. But, you know, listening to you talk, it sounds like a brain network problem. Even the word “functional”, to me, it seems a little judgmental. I don't know if this is the best term, but is this really a network problem? Dr Stone: The word “functional”, for most neurologists, sounds judgmental because of what you associate it with. If you think about what the word actually is, it's- it does what it says on the tin. There's a disordered brain function. I mean, it's not a great word. It's the least worst term, in my view. And yes, of course it's a brain network problem, because what other organ is it going to be? You know, that's gone wrong? When software brains go wrong, they go wrong in networks. But I think we have to be careful not to swing that pendulum too far to the other side because the problem here, when we say asking the question, is this a mental health problem or a neurological one, we're just asking the wrong question. We're asking a question that makes no sense. However you try and answer that, you're going to get a stupid answer because the question doesn't make sense. We shouldn't have those categories. It's one organ. And what's so fascinating about FND---and I hope what can incite your sort of curiosity about it---is this disorder which defies this categorization. You see some patients with it, they say, oh, they've got a brain network disorder. Then you meet another patient who was sexually abused for five years by their uncle when they were nine, between nine and fourteen; they developed an incredibly strong dissociative threat response into that experience. They have crippling anxiety, PTSD, interpersonal problems, and their FND is sort of somehow a part of that; part of that experience that they've had. So, to ignore that or to deny or dismiss psychological, psychiatric aspects, is just as bad and just as much a mistake as to dismiss the kind of neurological aspects as well. Dr Smith: I wonder if this would be a good time to go back and talk a little bit about a concept that I found really interesting, and that is FND as a prodromal syndrome before a different neurological problem. So, for instance, FND prodromal to Parkinson's disease. Can you talk to us a little bit about that? I mean, obviously I was familiar with the fact that patients who have nonepileptic seizurelike events often have epileptic seizures, but the idea of FND ahead of Parkinson's was new to me. Dr Stone: So, this is definitely a thing that happens. It's interesting because previously, perhaps, if you saw someone who was referred with a functional tremor---this has happened to me and my colleagues. They send me some with a functional tremor. By the time I see them, it's obvious they've got Parkinson's because it's been a little gap. But it turns out that the diagnosis of functional tremor was wrong. It was just that they've developed that in the prodrome of Parkinson's disease. And if you think about it, it's what you'd expect, really, especially with Parkinson's disease. We know people develop anxiety in the prodrome of Parkinson's for ten, fifteen years before it's part of the prodrome. Anxiety is a very strong risk factor for FND, and they're already developing abnormalities in their brain predisposing them to tremor. So, you put those two things together, why wouldn't people get FND? It is interesting to think about how that's the opposite of seizures, because most people with comorbidity of functional seizures and epilepsy, 99% of the time the epilepsy came first. They had the experience of an epileptic seizure, which is frightening, which evokes strong threat response and has somehow then led to a recapitulation of that experience in a functional seizure. So yeah, it's really interesting how these disorders overlap. We're seeing something similar in early MS where, I think, there's a slight excess of functional symptoms; but as the disease progresses, they often become less, actually. Dr Smith: What is the prognosis with the types of physical therapy? And we haven't really talked about psychological therapy, but what's the success rate? And then what's the relapse rate or risk? Dr Stone: Well, it does depend who they're seeing, because I think---as you said---you're finding difficult to get people in your institution who you feel are comfortable with this. Well, that's a real problem. You know, you want your therapists to know about this condition, so that matters. But I think with a team with a multidisciplinary approach, which might include psychological therapy, physio, OT, I think the message is you can get really good outcomes. You don't want to oversell this to patients, because these treatments are not that good yet. You can get spectacular outcomes. And of course, people always show the videos of those. But in published studies, what you're seeing is that most studies of- case series of rehabilitation, people generally improve. And I think it's reasonable to say to a patient, that we have these treatments, there's a good chance it's going to help you. I can't guarantee it's going to help you. It's going to take a lot of work and this is something we have to do together. So, this is not something you're going to do to the patient, they're going to do it with you. Which is why it's so important to find out, hey, do they agree with you with the diagnosis? And check they do. And is it the right time? It's like when someone needs to lose weight or change any sort of behavior that they've just become ingrained. It's not easy to do. So, I don't know if that helps answer the question. Dr Smith: No, that's great. And you actually got right where I was wanting to go next, which is the idea of timing and acceptance. You brought this up earlier on, right? So, sometimes patients are excited and accepting of having an affirmative diagnosis, but sometimes there's some resistance. How do you manage the situation where you're making this diagnosis, but a patient's resistant to it? Maybe they're fixating on a different disease they think they have, or for whatever reason. How do you handle that in terms of initiating therapy of the overall diagnostic process? Dr Stone: We should, you know, respect people's rights to have whatever views they want about what's wrong with them. And I don't see my job as- I'm not there to change everyone's mind, but I think my job is to present the information to them in a kind of neutral way and say, look, here it is. This is what I think. My experience is, if you do that, most people are willing to listen. There are a few who are not, but most people are. And most of the time when it goes wrong, I have to say it's us and not the patients. But I think you do need to find out if they can have some hope. You can't do rehabilitation without hope, really. That's what you're looking for. I sometimes say to patients, where are you at with this? You know, I know this is a really hard thing to get your head around, you've never heard of it before. It's your own brain going wrong. I know that's weird. How much do you agree with it on a scale of naught to ten? Are you ten like completely agreeing, zero definitely don't? I might say, are you about a three? You know, just to make it easy for them to say, no, I really don't agree with you. Patients are often reluctant to tell you exactly what they're thinking. So, make it easy for them to disagree and then see where they're at. If they're about seven, say, that's good. But you know, it'd be great if you were nine or ten because this is going to be hard. It's painful and difficult, and you need to know that you're not damaging your body. Those sort of conversations are helpful. And even more importantly, is it the right time? Because again, if you explore that with people, if a single mother with four kids and, you know, huge debts and- you know, it's going to be very difficult for them to engage with rehab. So, you have to be realistic about whether it's the right time, too; but keep that hope going regardless. Dr Smith: So, Jon, there's so many things I want to talk to you about, but maybe rather than let me drive it, let me ask you, what's the most important thing that our listeners need to know that I haven't asked you about? Dr Stone: Oh God. I think when people come and visit me, they sometimes, let's go and see this guy who does a lot of FND, and surely, it'll be so easy for him, you know? And I think some of the feedback I've had from visitors is, it's been helpful to watch, to see that it's difficult for me too. You know, this is quite hard work. Patients have lots of things to talk about. Often you don't have enough time to do it in. It's a complicated scenario that you're unravelling. So, it's okay if you find it difficult work. Personally, I think it's very rewarding work, and it's worth doing. It's worth spending the time. I think you only need to have a few patients where they've improved. And sometimes that encounter with the neurologist made a huge difference. Think about whether that is worth it. You know, if you do that with five patients and one or two of them have that amazing, really good response, well, that's probably worth it. It's worth getting out of bed in the morning. I think reflecting on, is this something you want to do and put time and effort into, is worthwhile because I recognize it is challenging at times, and that's okay. Dr Smith: That's a great number needed to treat, five or six. Dr Stone: Exactly. I think it's probably less than that, but… Dr Smith: You're being conservative. Dr Stone: I think deliberately pessimistic; but I think it's more like two or three, yeah. Dr Smith: Let me ask one other question. There's so much more for our listeners in the article. This should be required reading, in my opinion. I think that of most Continuum, but this, I really truly mean it. But I think you've probably inspired a lot of listeners, right? What's the next step? We have a general or comprehensive neurologist working in a community practice who's inspired and wants to engage in the proactive care of the FND patients they see. What's the next step or advice you have for them as they embark on this? It strikes me, like- and I think you said this in the article, it's hard work and it's hard to do by yourself. So, what's the advice for someone to kind of get started? Dr Stone: Yeah, find some friends pretty quick. Though, yeah, your own enthusiasm can take you a long way, you know, especially with we've got much better resources than we have. But it can only take you so far. It's really particularly important, I think, to find somebody, a psychiatrist or psychologist, you can share patients with and have help with. In Edinburgh, that's been very important. I've done all this work with the neuropsychiatrist, Alan Carson. It might be difficult to do that, but just find someone, send them an easy patient, talk to them, teach them some of this stuff about how to manage FND. It turns out it's not that different to what they're already doing. You know, the management of functional seizures, for example, is- or episodic functional movement disorders is very close to managing panic disorder in terms of the principles. If you know a bit about that, you can encourage people around you. And then therapists just love seeing these patients. So, yeah, you can build up slowly, but don't- try not to do it all on your own, I would say. There's a risk of burnout there. Dr Smith: Well, Dr Stone, thank you. You don't disappoint. This has really been a fantastic conversation. I really very much appreciate it. Dr Stone: That's great, Gordon. Thanks so much for your time, yeah. Dr Smith: Well, listeners, again, today I've had the great pleasure of interviewing Dr Jon Stone about his article on the multidisciplinary treatment for functional neurologic disorder, which he wrote with Dr Alan Carson. This article appears in the August 2025 Continuum issue on movement disorders. Please be sure to check out Continuum Audio episodes from this and other issues. And listeners, thank you once again for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. We hope you've enjoyed this subscriber-exclusive interview. Thank you for listening.

ASHP's senior education director, Cindy Von Heeringen is joined by James Hoffman, senior vice president of quality and safety, member, pharmacy and pharmaceutical sciences at St. Jude Children's Research Hospital, and Joe DiPiro, professor emeritus at Virginia Commonwealth University, School of Pharmacy, as they discuss their upcoming Midyear session that focuses on relevant trends in the external environment that will have a major impact on health-system pharmacy practice over the next five years.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Before Sir Alec Guinness was Obi-Wan Kenobi, he adapted Joyce Cary's book The Horse's Mouth into the 1958 movie. In addition to writing the screenplay, Guinness starred as Gulley Jimson, an artist who is dedicated but snide, talented but demanding, endearing but dishonest. Jimson charms and delights, and nothing will get in the way of his vision. Even worse, he leaves havoc in his wake. Roymieco Carter, who's Associate Professor and Director of the Visual Arts Program at North Carolina A&T State University, discovered the movie when he was a student at Virginia Commonwealth University, and it made a big impact. Carter explains why The Horse's Mouth impacted him at such an early age, and why asking for permission to be an artist or designer isn't necessary, if you want to be something, be it.-Associate Professor and Director of the Visual Arts Program at North Carolina A&T State University, Roymieco Carter teaches graphic design, digital media, visual literacy and theory, and social criticism. Carter has written articles on graphic design education, art education, gaming, human computer interaction, and graphics computer animation. Having studied and worked in fashion art, as well as design and advertising practices, he often draws from his graphic design background for inspiration. His work uses a mixture of digital and hand techniques including collage, calligraphy, drawing, xerography, stenciling and typography. Raised in the tobacco farmlands of Virginia, he draws inspiration from his rural upbringing, and integrates themes of violence, displacement, and oppression into his work, exploring how history is manipulated and rewritten. Holding a BFA in Art and Advertising from Virginia Commonwealth University and an MFA in Graphic Design from Penn State University, Carter's work fuses documented history with cultural narratives and folklore, evoking deep emotional and personal insights.https://cartergallery.wordpress.com/ https://www.linkedin.com/in/roymieco-carter-65a38827/ https://www.ncat.edu/employee-bio.php?directoryID=909381433 https://www.ganttcenter.org/calendar/open-air-steven-cozart-and-roymieco-carter/ -The Horse's Mouth (1958)https://www.imdb.com/title/tt0051739/https://www.tcm.com/video/223317/horses-mouth-the-1958-the-old-dreadnought -Further Readinghttps://en.wikipedia.org/wiki/Mihaly_Csikszentmihalyi https://en.wikipedia.org/wiki/No_Church_in_the_Wild https://www.museepicassoparis.fr/en/picassos-childhood -Thirtysomething (1987-1991)https://en.wikipedia.org/wiki/Thirtysomethinghttps://designobserver.com/i-was-a-mad-man/ https://slate.com/news-and-politics/2001/05/miles-drentell-r-i-p.html https://som.yale.edu/blog/memoriam-bill-drenttel-Other movies and shows discussed, alphabetical listSinners (2025)Taxi Driver (1976)

Send us a textOne is better than two when it comes to the Martelli Family. So we welcome back new VCU Head Men's Basketball Coach Phil Martelli Jr. and his little brother new VCU Associate Head Men's Basketball Coach Jimmy Martelli to the Full Court Press : A College Basketball Coaches Show as we talk all things great about VCU Hoops, their epic fan and alumni base, the ROCKING Siegel Center and the Richmond Community. The Martellis also share some insight and some funny stories about growing up in a hoops household. We are huge fans of them and Year 1 of the Martelli Experience is going to be FUN!SUBSCRIBE to the Full Court Press YOU TUBE channel:https://www.youtube.com/@FullCourtNetworkJOIN AND SUBSCRIBE THE FULL COURT NETWORK SUBSTACK PAGE:https://fullcourtnetwork.substack.com/

Jonathan Bennet, owner of Unsprung Upholstery is originally from Martinsville, VA.  He caught the sewing bug from his great grandmother at a young age. He moved to Richmond, VA on a whim in August of 1989 and earned a BFA in Fashion Design from Virginia Commonwealth University. Directly after graduation, Jonathan taught in the Fashion Design department as an adjunct professor for 13 years. He started his first workroom job in 1997, learned how to make various types of window treatments, cushions, pillows, and more;  since then, he has done freelance workroom client projects in his home for over 25 years. Jonathan opened Unsprung Upholstery LLC in August 2019 and will continue this beautiful journey for the rest of his life!   Website:  UnsprungUpholstery.com IG:  UnsprungUpholstery FB:  Unsprung Upholstery Company   Links and Resources; The Custom Workroom Conference Window Covering Association of America Scholarship Info

Tim Kontos is the Associate AD for Sports Performance and Student-Athlete Wellness at Virginia Commonwealth University. Kontos is going into his 27th year at VCU. First arriving in 1998 as the head strength and conditioning coach, he became an assistant athletic director for sports performance and was again promoted to associate AD before his new title of associate AD for sports performance and student-athlete wellness. From August of 2018 to January of 2021 Kontos supervised the Sports Medicine, Sports Nutrition, Sport Psychology and Sports Performance departments. This was in addition to being responsible for the design, implementation and supervision of all strength, speed and agility programs for The Rams' Baseball and Volleyball teams. He currently oversees the Volleyball program in addition to the Sports Performance department. Kontos got his coaching start at his alma mater, Radford University, where he spent two years serving as the strength and conditioning coach for the ice hockey team, prior to joining VCU. Kontos is a Master Strength & Conditioning Coach through the Collegiate Strength and Conditioning Coaches Association earning the highest honor in the profession in 2015. He is also the Head Coach and Owner of Kontos Strength which is an online platform that offers custom programming and coaching, including return from injury and competition prep. A firm believer in learning “under the bar” Kontos was a competitive powerlifter from 1994 until retiring due to injuries in 2023. His best lifting accomplishment? A competition best 600lb Squat in knee wraps at 198lbs. In his off time Kontos enjoys being outside with his wife, Laura, and kids Alex, Zane, and Moriah. Samson EquipmentSamson Equipment provides Professional Weight Room Solutions for all your S&C needs.Cerberus StrengthUse Code: STRENGTH_GAME at Cerberus-Strength.comSport KiltUse Code: TSG at SportKilt.comDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show

We are going back in time and discussing Amatory Fiction in the 18th century novel Fantomina by Eliza Haywood. This incredible story explores the complexities of identity and desire through the story of a young woman who adopts multiple personas to navigate the intricacies of romantic entanglements in 18th-century society. This provocative tale delves into themes of gender, autonomy, and the hidden depths of passion, highlighting the lengths one will go to in pursuit of love and self-discovery.Samantha DeShazo was born and raised in Richmond, Virginia. She earned her MA in English at Virginia Commonwealth University in 2022, where she studied literature of the long eighteenth century. She is an educator who currently works with first year college students. When she's not working, she can be found with her nose in a book or pampering her beloved dog, Henry. Our drink this week was courtesy of Samantha, it is a Creme Earl Grey Black Tea fromThe Spice & Tea Exchange of Richmond. It is absolutely delicious, smells like Fruity Pebbles, and would definitely have been all the rage in Fanomina's timeIn this EpisodeFantomina by Eliza HaywoodThe Spice & Tea Exchange of RichmondToni MorrisonFrankstein by Mary ShelleyThe Law of CovertureDidn't Read It Podcast Fantomina EpisodeAmatory FictionSense and Sensibility by Jane AustenPamela by Samuel RichardsonLove in Excess by Eliza HaywoodBetsy Thoughtless by Eliza Haywood

Bizable https://GoBizable.comUntie your business exposure from your personal exposure with BiZABLE.  Schedule your FREE consultation at GoBizAble.com today. Angel Studios https://Angel.com/ToddJoin the Angel Guild today and stream Testament, a powerful new series featuring the retelling of the book of Acts. Renue Healthcare https://Renue.Healthcare/ToddRegister today to Join the Renue Healthcare Webinar Thursday September 11th at 11:00 PST.   Visit https://joinstemcelltalks.com or call 602-428-4000.  Bulwark Capital https://KnowYourRiskPodcast.comBe confident in your portfolio with Bulwark! Schedule your free Know Your Risk Portfolio review. Go to KnowYourRiskPodcast.com today. Alan's Soaps https://www.AlansArtisanSoaps.comUse coupon code TODD to save an additional 10% off the bundle price.Bonefrog https://BonefrogCoffee.com/toddThe new GOLDEN AGE is here!  Use code TODD at checkout to receive 10% off your first purchase and 15% on subscriptions.LISTEN and SUBSCRIBE at:The Todd Herman Show - Podcast - Apple PodcastsThe Todd Herman Show | Podcast on SpotifyWATCH and SUBSCRIBE at: Todd Herman - The Todd Herman Show - YouTubeWhy children? Why did God create them? If we ask this question, and then look at how children are being treated in society, we can learn a lot...Episode Links:Terry McAuliffe: “Glenn Youngkin is a right-wing culture warrior who wants to ban books, abortion, and gay marriage. That's not who we are in Virginia. It's up to us to choose a better way.”Virginia Gov. Youngkin orders investigation into school's alleged role in arranging abortions'I am deeply concerned with the allegations that Fairfax County Public Schools officials arranged for minors to get abortions without parental consent and may haveBravo! College graduates at Virginia Commonwealth University walkout during MAGA fascist, Trump-loving governor Glenn Youngkin's commencement address.Florida arrests 48 suspected child predators in major undercover operation; Seven of those arrested are under ICE detainment, paving the way for federal custody and potential deportation proceedings."The UN's Agenda 2030 is all about control." English broadcaster Bev Turner: "It is not possible to achieve these utopian ideals without a deliberate... redistribution of food, goods, property and rights."

BUFFALO, NY – August 19, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on August 19, 2025, titled “The SCD1 inhibitor aramchol interacts with regorafenib to kill GI tumor cells in vitro and in vivo.” In this study, led by first authors Laurence Booth and Michael R. Booth, along with corresponding author Paul Dent from Virginia Commonwealth University, researchers investigated how aramchol, a drug originally developed for liver disease, works with the cancer drug regorafenib in gastrointestinal (GI) tumor cells. They found that the combination is effective, especially in tumor cells with a specific genetic variant. The combined approach offers a potential new strategy for treating liver and colon cancers. Gastrointestinal cancers, such as liver and colon cancer, are serious global health challenges. Regorafenib, already approved for cancer treatment, can have limited impact and frequently causes side effects. Aramchol, a drug developed to treat fatty liver disease, affects how cancer cells process fats and energy. In this study, researchers tested whether combining these two drugs could improve GI cancer treatment, both in cells and mouse models. The results showed that the drug combination killed liver and colorectal cancer cells more effectively than either drug alone. In animal models, mice with human liver tumors had slower tumor growth, without showing signs of weight loss or other toxicity. The researchers also found that aramchol and regorafenib work together to block important survival pathways inside cancer cells. This combination was especially effective in cells with a genetic variant called ATG16L1 T300, which is more common in people of African ancestry. The treatment triggered stress responses in the cancer cells and disrupted key proteins required for survival. It also activated autophagy, a natural recycling process that clears out damaged parts, eventually leading to cancer cell death. “Aramchol interacted with the multi-kinase inhibitors sorafenib, regorafenib or lenvatinib, to kill GI tumor cells, with regorafenib exhibiting the greatest effect.” Aramchol is currently in clinical trials for fatty liver disease and has a well-established safety profile, while regorafenib is already FDA-approved for cancer treatment. Together, their combination could advance fast into clinical testing for patients with GI cancers. However, researchers note that additional studies are needed to support the launch of early-phase clinical trials. Altogether, this study may offer a more effective and less toxic alternative to current treatments for GI cancers. It also highlights the role of genetic variants in shaping treatment response, suggesting that future therapies could be more precisely tailored to each patient's unique genetic profile. DOI - https://doi.org/10.18632/oncotarget.28762 Correspondence to - Paul Dent - paul.dent@vcuhealth.org Video short - https://www.youtube.com/watch?v=5saAqsqxi-Q Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28762 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, macroautophagy, flux; ER stress, aramchol, regorafenib To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Jason Lesandrini, PhD, FACHE, LPEC, HEC-C, Assistant Vice President of Ethics, Advance Care Planning, Spiritual Health, and Language Access Services at Wellstar Health System, and Kelsey B. White, PhD, BCC, Assistant Professor and Chaplaincy Faculty Researcher at Virginia Commonwealth University, and Editor-in-Chief of the Journal of Health Care Chaplaincy, discuss improving the patient experience through the integration of chaplaincy and ethics services. They highlight the vital role of chaplains, the importance of supporting workforce well-being, and strategies to relieve clinician burnout in a changing healthcare environment.

Episode No. 715 features artist Kandis Williams. The Walker Art Center, Minneapolis is presenting "Kandis Williams: A Surface," the first survey of Williams' career. The exhibition spotlights how Williams has used collage as a tool of Black feminist resistance, to dismantle entrenched histories and power structures, and to rebuild dominant narratives. The exhibition, which was curated by Taylor Jasper with Laurel Rand-Lewis, is on view through August 24. The exhibition catalogue was published by the Walker. Amazon and Bookshop offer it for around $45. Williams is also included in "Performance on Paper" at the Hammer Museum, University of California, Los Angeles. It features prints and drawings created at the intersection of music and dance by about twenty artists active from the 1960s to the present. It was curated by Naoko Takahatake with Jennie Waldow, and is on view through August 10. Williams' previous museum solo exhibition was at the Institute for Contemporary Art, Virginia Commonwealth University. They have been included in group exhibitions at the Museum of Modern Art, New York, the Frye Art Museum, Seattle, at the Studio Museum in Harlem, and in the Hammer Museum's Made in LA biennial. Instagram: Kandis Williams, Tyler Green.

David Waldman is BACK for the Friday KITM, then GONE for the weekend, then BACK on the Monday KITM! See how that works? In local, to KITM World Headquarters, news, the University of Virginia and Virginia Commonwealth University can't operate any “illegal” DEI programs to get federal funding, and they really like federal funding, therefore they're obeying anticipatorily.  The White House appreciates their cooperation and will now require the resignation of the University of Virginia's president. In even more local news, the Superintendent of Loudoun Schools, Aaron Spence eloquently describes how Trump can kiss his DEI-loving ass. Meanwhile, a selling point for a four-year degree has always been where you'll be spending those four years. People assumed someone had fixed the DOGE by cutting off Big Balls, but he's only been tucked away, out of sight. The US is slashing overseas pro-democracy initiatives, yet Samuel Samson over at the US State Department wanted your tax money to go to anti-democracy initiatives to support Marine Le Pen.  Le Pen had the self-respect to turn him down. Remember when real men were both strong and silent? Why can't we try bringing back those days again? Why are supervillains always such big mouths?

David Wojahn grew up in St. Paul, Minnesota. He studied at the University of Minnesota and the University of Arizona. Ever since his first collection, Icehouse Lights, was chosen for the Yale Series of Younger Poets award in 1981, Wojahn has been one of American poetry's most thoughtful examiners of culture and memory. His work often investigates how history plays out in the lives of individuals, and poet Tom Sleigh says that his poems “meld the political and personal in a way that is unparalleled by any living American poet.”Wojahn's book World Tree (2011) received the Lenore Marshall Poetry Prize from the Academy of American Poets. His collection Interrogation Palace: New and Selected Poems 1982–2004 (2006), which Peter Campion called “superb” and “panoramic” in a review for Poetry, showcases Wojahn's formal range, the scope of his personal narratives, and his intense, imaginative monologues and character sketches, such as his sonnets on pop culture icons and rock-and-roll musicians in Mystery Train (1990). He is also celebrated for the emotional resonance of his poetry—the ability to, in the words of poet Jean Valentine, “follow … tragedy to its grave depths, with dignity and unsparingness, and egolessness.”In addition to his books of poetry, Wojahn is the author of From the Valley of Making: Essays on the Craft of Poetry (2015) and Strange Good Fortune (2001), a collection of essays on contemporary poetry. He coedited A Profile of Twentieth Century American Poetry (1991), and edited a posthumous collection of his wife Lynda Hull's poetry, The Only World (1995).Wojahn has received fellowships from the Guggenheim Foundation, the National Endowment for the Arts, the Fine Arts Work Center in Provincetown, the Illinois Arts Council, and the Indiana Arts Commission. He teaches poetry at Virginia Commonwealth University and in the low residency MFA in Writing program at the Vermont College of Fine Arts.-bio via Poetry Foundation This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit dailypoempod.substack.com/subscribe